top 7 reasons to howl at the moon

I need to learn to write when I'm angry. I've never been able to do that, so here I am forcing myself. Anger makes me turn away from things that are good for me. I stop cooking, I stop taking my vitamins, I stop talking to all the people who love me, I stop doing my laundry. This blog has been a good thing for me, so I stop blogging too.

Last Wednesday we got the results of Angel Mae's visual autopsy and the pathology report on my bloodwork. Baby looked completely normal, but they found signs of acute infection in my placenta. Infection can be dangerous to mom and baby. Basically the infection caused my body to dump the pregnancy.

Does it help to know? Yes, I guess so. Many people lose their babies and never get answers. None. At. All. And they have to live with that forever. So I'm a little grateful. It is a closure of sorts. But let me count the ways that this information makes me angry.

1) This problem was not on our radar AT ALL. I was being watched for a troublesome polyp, confusing bleeding, and a cervix that may or may not have been popping open. Our answer? D. None of the above. A totally new, different, and scary pregnancy problem to add to our long list. Not only did this pregnancy result in no baby, but there was nothing normal or blissful about it from beginning to end.

2) It's too STUPID. Germs killed the baby. Somewhere along the line someone's hands weren't clean. Or I piece of chicken I ate wasn't quite at 160 degrees. I thought did everything I was supposed to do - washed my hands, avoided cat litter and sushi, didn't share needles, yadda yadda. If you go online and look for information on how to reduce your risk of infection, it's all that common sense stuff - plus the cat litter and deli meats thing. Could I have been more vigilant? Probably. But I think I was the normal amount of vigilant that most pregnant women are. For most women, that's enough to keep their babies safe. But not me.

3) And I sort of maybe found out why. From Dr. Google. Apparently women with cervical problems (do I or don't I?) and/or who get more exams (I did) are at greater risk for infection. Great. Of the dozen or more practitioners I saw during this pregnancy, not one doctor, nurse, or midwife shared that info with me. No one said, hey we don't want to scare you but since we don't know what's going on with your cervix, be extra sure your house is clean and maybe take some extra vitamin C. Or whatever.

4) It's not a random lightening strike. It could happen AGAIN. Women who go into preterm labor once are more likely to have preterm labor in a subsequent pregnancy. So in my next pregnancy it would be, Dear God please just let me make it to 30 weeks this time... Also women with infections in one pregnancy are at double the risk for one in their next pregnancy. That means me. So not only do I have to sit here with the loss of my daughter but also with the knowledge that if I want to have a baby and do get pregnant again, I've got a better chance than most of that baby dying or being born sick or disabled. Fantastic.

5) So what's my risk factor for another infection? The one stat I keep running into says that infection occurs in 1/2% to 10% of all pregnancies (but doesn't necessarily cause PTL). So if my risk factor doubles, that means I have a 1% to 20% chance of infection? MOST. USELESS. STAT. EVER. This stat just pisses me off.

6) My doctor tried to tell me that this was a miscarriage, and that it is only stillbirth after 24 weeks. Now, I've spent a lot of time with Dr. Google, and EVERYTHING I've read says 20 weeks. Including the autopsy report, which referred to her death as a stillbirth and in most places referred to Angel Mae as a baby not a fetus. Which actually means a lot to me. I'm really not trying to compare losses or to knock anyone who has experienced the real grief of miscarriage, or pregnancy loss in any form. And I know that all our language around pregnancy is awfully wrapped up with politics, and the distinction between fetus and baby has a lot of emotional charge for some people. But I am saying that what I experienced in my body, in that room, was labor and stillbirth of a baby (really, she came with a hat and everything).

And it would have been helpful for my doctor to acknowledge that. But she didn't really. Nor did she say, "sorry for your loss" or anything close to that. Because I think she's got something else going on - something ethical or political or personal that creeps over into her patient care. I think 25 weeks is the cut off in this state for abortions and medical terminations. So something in her doesn't want to think of anything earlier than that as a baby. Which, you know, is tricky when theoretically her job is to help me have a baby. It explains her really hands off approach with me. If I had made it to 25 weeks I wonder if she would have stepped up more, because you know, NOW it's a baby. But possibly not even then, because she also indicated that she's uncomfortable with how much we do to keep micropreemies alive. She once told me it would be better to miscarry at 14 weeks than to have a baby at 25. Which is a valid perspective, but do you really say it to a pregnant lady's face? Maybe I'd have to get to 34 weeks before she would have been really into helping me stay pregnant. Because, you know, now it's an OKAY baby. Which brings me to...

7) This was not a PRACTICE baby or a GOOD LEARNING EXPERIENCE. Yes, I now know a lot more about cervical insufficiency, infections, preterm labor, available treatments, precautions, types of doctors, etc. Yes, I will know better what to do next time. But is there some reason all that info wasn't put in front of my face as soon as THIS pregnancy started to look complicated? This wasn't a dry run, and my doctor has a little bit of the "well, now we know" attitude going on. Even one of the floor nurses, who was generally great, said to us, as we were saying goodbye to Angel Mae, "Come back next time for the good one." Meaning, the baby who will live. Fat chance.

There's a long list of people to be angry with, even though, ultimately no one is to blame. I'm also mad at GERMS, which is super productive! And God, the Universe and Everything for making me one of those women for whom pregnancy is a terrifying ordeal resulting in failure. And of course I'm angry with myself. I should have asked more questions. I should have pushed harder for answers, for second opinions. I should have done more research. Because now I know that the worst can happen. To anyone, not just me. There are so many stories. Now I know what the real game is, and if there's a next time, I'll play the game better. But that's no consolation at all.