We are doing one more go! A new pregnancy is underway. Our first baby is now 19 months old, wild, feisty, so cute, and doing well. It has been such an adventure raising him. So different from infertility struggles. That sounds obvious, but somehow I thought infertility would toughen me up or something, but this is just so different. It doesn't stop! So I didn't feel emotionally prepared. It is easier and harder. But I man also so grateful, that our guy is here, doing well. He's amazing. The challenge is just getting enough rest and down time, and not letting the overstimulation make me and my husband crazy (introverts over here).

That said, we always said we wanted two kids, so we decided to do another embryo transfer (we have too many embryos, so that's not a problem). That was in March, and the embryo transfer was fine. That's the easy part! Now I am 14 weeks pregnant. All is going well, but I am trying to navigate my own issues so I don't have too much trouble during this pregnancy.

Anxieties and Blood Pressure

Overall my health is very good. The one thing that is such a pain, is my blood pressure can go up just into the hypertension range when I go into the clinic. It did this at my last appointment and I had a big talk with my midwife about it. I took my blood pressure twice a day for a week and sent her all those numbers. It was fine and normal at home except for one reading where I was feeling extra anxious. But two minutes later it was normal. So, pretty classic white coat syndrome. This doesn't seem too shocking given my medical history, I've had some bad times in doctors offices.

White coat syndrome is extra annoying in pregnancy because they make such a fuss as high blood pressure can be a sign of pre-eclampsia. Of course I don't want to mess around with that, but I also want to learn to relax my system so I don't have more trouble than necessary. I do have risk factors for gestational hypertension - being over 40 (I'm 44 now), doing IVF, and using donor eggs, plus there is hypertension in my family. So my midwife wants to be careful, and that is reasonable. She did say that they would rely more on my home numbers than the office numbers for treatment plans, and I appreciate that.

Reflecting on my last pregnancy

As I have been trying to solve this problem, I have been reflecting on my experience with my last pregnancy. Generally the pregnancy and birth all went well. Birth trauma is very common, and while I don't think I have that, I did have a bad experience after my baby's birth, which definitely adds to the anxiety around this upcoming birth.

At the end of my pregnancy my blood pressure in office went up to 130/90 or so. When it's 140/90 - either number - it counts as hypertension, so my OB marked me as gestational hypertension and sent me straight to the hospital for induction. As it happens I had been having contractions all night, and was 6 cm dilated and 100% effaced by the time I strolled into the hospital and calmly ate a burrito in the waiting room (the receptionist seemed a bit shocked that I was so relaxed with those numbers).

I have been reading up on childbirth and I think it's likely that my labor stalled because of the stress of going into the clinic. Since oxytocin is the hormone that fuels labor, and that is a calm, snuggly hormone. Pitocin, the drug they use for induction, is synthetic oxytocin.

Anyway, it got going again some hours later. They did give me the lowest dose of pitocin, and turned it off half an hour later, because I went from pretty chill to very intense contractions almost not stopping, very quickly. I wish I could have had less stress around the whole thing and had less pressure from the nurses and midwives. I was already in labor and I feel it was unnecessary. I get that they were being cautious, but it all felt stressful and I wanted people to stop bothering me and making it a big deal when I felt things were fine. Maybe I'm wrong and was in danger and needed the pitocin. I can't be sure. It was all a bit of a haze, but I just wanted to feel calm and relaxed and wasn't worried, and wished everyone would stop making a fuss.

Anyway. After that they were fussy about my blood pressure and had me stay three days in hospital and didn't stop reminding me that blood pressure can spike on day three, and seemed worried that if I went home I'd have a stroke. Meanwhile, I hadn't slept worth a darn the night before my delivery, and then was handed a fussy newborn who wouldn't sleep, and my husband and I were alone in the room with this new baby and neither of us could get any rest, and it was fully horrible. The nurses kept coming in to bother me and fuss about my blood pressure. I think I was having some anxiety and depression, I was feeling a bit crazy, and just wanted to walk out the door and make it all stop.

That is high on my list of things I want to avoid this next birth. First off, I want everyone to be healthy, of course. And after that, I want to set up a plan that doesn't destroy my physical and mental health. I was just so exhausted I couldn't see straight. The food was bad. The nurses didn't seem worried about anything except my blood pressure, and I was having a really hard time, and couldn't access things that would help me, like decent food from home, the quiet of my own bed, and not being woken when I did sleep, by nurses pestering me for vitals and offering their small threatening comments about having a stroke if I go home. And after a couple of days, I felt trapped and was climbing the walls.

So this time around...

I have been reading up, trying to find resources to help me with my anxiety about how things went last time, plus plan for a better experience.

I am reading Natural Hospital Birth, by Cynthia Gabriel, which is great. She has a lot of helpful suggestions about making a hospital birth more holistic. The goal is to make the body feel safe in the environment, not just the mind. I wish I had an alternative to a hospital birth, but my insurance doesn't cover any birthing centers or other hospitals, and I don't quite feel comfortable planning a home birth. I do feel that being in the hospital increases my stress a lot though, which makes all of these interventions more likely. I hate that. So I am working on answers.

I am sure that all this wouldn't be such an issue if it weren't for my history of fertility related trauma. The hospital is where they had to patch me back together when I had a ruptured ectopic pregnancy. I have had so many upsetting appointments, IVF, a D&C and the ultrasound where they told me my baby had no heartbeat. So all of that convinces my body we are in dangerous territory. I am looking into therapists and seeing what I can do to unwind that trauma response. If I could get my body to feel secure when I go in for appointments, I'd be just fine. So that's the goal.

General Health

In the meanwhile, I am doing my best to take great care of myself, so my health is as good as I can make it. I have been reading Aviva Romm's book, Natural Health for Pregnancy, which has suggestions for herbs that are safe in pregnancy (from the second trimester onward) and can be used for stress and stress induce high blood pressure. The occasional cup of skullcap, chamomile or lemon balm tea feels good, and I will add in some hawthorn in as well. There aren't as many studies as we would wish confirming the safety of herbs in pregnancy, but I need help, so I am choosing to trust the knowledge of these midwives and the data that is out there. It is tough to feel like pregnancy increases my anxiety and the trauma response that I have, and takes away the options I have for solving that anxiety.

I am eating well, stopped eating so many olives because of the salt content (they say it depends on the person whether salt effects blood pressure or not, but reducing processed foods never hurts, and processed food is the main source of high salt content). I'm eating fish or chicken a couple of times a week, I'm leaning on olive oil and avocado oil instead of butter, I'm eating beets every day, and lots of veggies. Pretty good, right? Generally a Mediterranean inspired diet.

I am generally working on my anxiety levels, and take magnesium daily. Last night I did a 20 minute epsom salt bath (not too hot), and followed that with 10 minutes of cardio, and I felt better than I had in ages. I have a feeling that cardio will help to reduce my resting heart rate and burn off some of the stress hormones that are probably coursing through my body way too much. I have never been good at cardio and I suspect that it will make a difference if I can get into a habit of doing that. We are looking at getting a stationary bike to make it easy and mindless. I just want to do cardio and watch Miss Marple! So it doesn't take any brain power. My brain is tuckered out, it needs a break!

I am journaling as often as I can (these mornings where I wake early and my toddler sleeps in, are precious!) I always used quiet time outside and journaling to restore my self, and it's hard to get any down time with a toddler. I am trying to find a therapist, but it's hard, so I'm doing my best with the tools I have.

Pregnancy in General

So that's the update right now. We made it through the 12 week ultrasound and NIPT (non invasive prenatal testing) blood test and everything looks great. If I can just keep my chill, we should be on track. Time is going by as it does, but I am so looking forward to having a complete family, with both my babies here with me, and never being pregnant again. Ha!