When I found out I was expecting my oldest son, it was the fourth time I had been told I was pregnant. Three times before, I had taken a pregnancy test and watched it turn positive. Three times before, I started bleeding eight or ten weeks into my pregnancy and bled until my womb was empty. Discovering I was pregnant a fourth time came with mixed emotions. Joy, because I very much wanted to be pregnant. Fear, because I had miscarried less than a year before. Profound doubt, because it didn’t seem real. And hope—always hope.
Experiencing multiple miscarriages
The Mayo Clinic says the risk of miscarriage in any pregnancy is around 14 percent, but around one percent of women—like me—experience two or more miscarriages. One percent is minuscule when you’re on the outside but from behind the wall of repeated loss, it seemed as if the odds were stacked against me and I would never be a mother. I was marked for failure.
What I had to keep reminding myself, like a mantra, was that even though I was a one-percenter with my three previous miscarriages, my overall risk of miscarriage was still only 28 percent, roughly a one in four risk. Having a 72 percent chance of not having a miscarriage should have been reassuring, but for a woman who had three previous miscarriages, who was over 40 and in a race against the clock, the reality was this: I didn’t believe I would ever be a mother.
The importance of self-advocacy
I’m confident that self-advocacy made all the difference in my situation. In researching causes of miscarriage, I kept running across articles that referenced a lack of progesterone as a potential reason for first-trimester miscarriage. Progesterone decreases naturally as we age, and if a woman has a progesterone deficiency when she becomes pregnant, it can lead to early miscarriage.
Some studies have suggested prescribing a progesterone supplement early in pregnancy might help prevent miscarriage. Was a lack of progesterone my problem? I didn’t know, but this information, this chance to do something to affect the outcome of my pregnancy, gave me a goal and a focus.
The gynecologist I saw when I had my third miscarriage ignored my concerns about progesterone deficiency and put it to me bluntly: at my age, with my history of miscarriage and uterine fibroids, I had a 3–5 percent chance of conceiving and carrying a baby to term. I was devastated, my mind once again fixating on statistics—this time an awful one—while he droned on about tests he wanted to schedule. I knew the window was closing on my chances to become a mother and that this doctor wasn’t going to listen to my concerns. So I walked out of his office and I never went back.
Validation and a new experience
Instead, within a few hours of my next positive pregnancy test eight months later, I scheduled an appointment with an ob/gyn who had been recommended by a friend. Because I was so early in my pregnancy, I was only able to see the nurse practitioner but she took my medical history, listened to my concerns, and passed them onto my new doctor—who saw me just a few days later. I explained to him that I had concerns about my progesterone level, though I’d never had my hormone levels tested when I wasn’t pregnant, and I was wondering if I might be a candidate for a supplement.
Taking a “can’t hurt, might help,” approach, he agreed it was worth a try and prescribed a progesterone suppository for me. I felt such an incredible sense of relief—not because I knew it would work but because I felt validated in my concerns. I felt heard for the first time in my pursuit of motherhood. And I felt like I was doing everything I could to make sure I stayed pregnant this time.
Doubts and fears
Even with the additional boost of progesterone, and the frequent OB-GYN visits because I was considered high risk due to my age and my previous miscarriages, it all still felt like a dream. I experienced no morning sickness, which seemed like an omen of doom rather than a blessing. And even as my waist expanded and I finally acknowledged in a crying freak out to my husband that I needed to buy maternity clothes, I still vacillated between believing that I was finally going to have a baby and thinking something awful would happen and I would never be a mother.
In those early weeks of my fourth pregnancy, each time I saw some spotting in my underwear, I caught my breath and got weepy. Through the first trimester, I took multiple pregnancy tests to reassure myself I was still pregnant. It was ridiculous, of course, because I knew the pregnancy hormones stayed elevated for a while even after a miscarriage. Still, the positive pregnancy tests, like the monthly ultrasounds, offered me the tangible comfort that I needed, especially when the statistics were against me.
Pregnancy after repeated loss meant putting all of my faith in something that had never worked before. Who does that, except the very young or the very foolish? I was neither, and I found myself clinging to cynicism and distancing myself from the identity of “mother.” Just in case, you know? I was quietly, joyously happy. But I felt like I had to exaggerate my quiet joy, put aside my fears and feel only joy, so people wouldn’t accuse me of being a pessimist or think I wasn’t happy about having a baby.
My joy was muted out of fear that my happiness would attract tragedy. I wanted to scream at the well-intentioned comments meant to bolster me when all they really did was make me feel like a time bomb waiting to explode. I knew it was only a matter of time until the clock counted down to zero and I lost everything.
Becoming a mother
But I didn’t. My pregnancy proceeded as normal and was, in fact, an easy physical experience. After all of the heartache, it seemed I was gifted with the best possible pregnancy I could have hoped for. Looking back, I can appreciate that I was never sick, that the only symptoms I had were minor and in my last trimester, that I felt good and was able to give birth to a healthy, big baby boy. But during my pregnancy, I could only wait for the other shoe to drop, for tragedy to strike, for things to go horribly wrong again. For the blood to come.
I caught my breath when I heard my son cry for the first time. And then I cried, too. It seemed as if I had been holding my breath since that first positive pregnancy test, waiting to exhale all of the worry, all of the sadness, all of the loss, and breathe in the joy. Breathe in his scent and know he was mine. It wasn’t until he took his first breath that I believed, yes, finally, I am a mother.
I didn’t know if it was self-advocacy that had made the difference, or simply luck. Then I got pregnant again when my son was a year old. Following the same progesterone supplement protocol, I wondered if lightning could possibly strike twice. It did. My second son was born 21 months after my first and it was no less precious to hear his first cry because I knew my family was now complete.