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06/15/2004

"It's still very early." Got it. Thanks.

There is a scary, mine-littered no-man's-land between being treated for infertility and being securely pregnant. I don't mean the social divide or the disconnect that exists in my own mind — I speak of the medical limbo you enter between a positive pregnancy test and your first visit to an OB.

I'm still seeing a reproductive endocrinologist for early scans, but, really, that's by default; once we've established that I'm pregnant and it hasn't implanted anywhere unorthodox, their work is done.

Sometimes that fact is uncomfortably obvious. Yesterday, after I'd left a couple of increasingly panicky messages, I finally spoke to a nurse. I told her about the staining I'd been experiencing and asked her whether it could be ascribed to my progesterone levels.

The nurse was unconcerned. I don't mean she was soothing and reassuring and told me I shouldn't be concerned. I mean she was unconcerned. I'm already on the highest dose of progesterone they prescribe, she told me, and I'd had a reassuring ultrasound. "We have no reason to think anything's changed," she said.

This reassured me for about half a second. But because apparently it's against some industry-wide ethical code to leave a patient feeling less than the maximum allowable amount of bone-deep terror, she continued with a warning: "Of course, it's still very early and anything can happen."

Yeah. Thanks. Third pregnancy, no babies. I'm reasonably clear on that point. 'Preciate the reminder.

What she said is true: we have no reason to believe anything's changed. (We won't discuss my suspicion that my breasts aren't as tender today as they were yesterday. We simply, absolutely will not.) So why am I not content?

I keep coming back to the fact that last time, I had no indication that the pregnancy was failing, even beyond the point where the embryo had died. No news is not necessarily good news.

There is nothing to do but wait, of course; I am trying to do so with grace, but failing. What we need is someone whose job it is to follow women from infertility treatment to the point where they feel confident in their pregnancies, to fill the gap between RE and OB. Someone to be reassuring where appropriate, but never unrealistic — kind but pragmatic, hopeful but sane. Someone who will distract and amuse, sympathize and encourage. Someone who gets paid to do what my friends here generously do as volunteers.

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