The light of a thousand suns

At 6 days past transfer (dpt), I was feeling viciously low.  Not only was I sad, I was angry, flying into rages at the slightest provocation.  I can't be sure, but I think that was the day Paul, a genius of self preservation, began wearing a cup.

At 7dpt, I went to my local RE's office for the luteal phase bloodwork Cornell requests.  I saw only the phlebotomist, who gasped sympathetically at the bruises that linger at my every venipuncture site.  Even with this limited exposure, being in the local office did a number on me — it's been the site of too many disappointments.  On the drive home, I was seized by a panic attack, and had to pull over as I hyperventilated, telling myself over and over, "We have burned through over $40,000 with nothing to show for it."

Okay.  So I didn't test on 7dpt, knowing that seeing a negative would only fuck me up even more. 

Good thing I didn't, because it would have been negative.

At 8dpt, I woke up early.  Now, I do this during the two-week wait (and beyond, if the situation warrants it).  I wake up to use the bathroom or to bat away the rough-tongued attentions of the cat, and I can't go back to sleep — my mind is too busy, considering every possibility, running endless diagnostics on my every reproductive apparatus.  I went to the bathroom, returned to bed, and tried to go back to sleep, but finally gave it up as a bad job at 5 AM.  And I lumbered off to the second bathroom to christen the first stick of IVF #4.

You have never seen a fainter positive in your life.

To see a second line, you'd have needed NASA-grade optics, the ability to convince yourself that the Earth is flat, and the light of a thousand suns.  But there was a second line.

I stared at the line for about an hour.  By 7 AM I could wait no longer, and made my poor beleaguered husband wake up, put on his reading glasses (or as we call them in these days of PIO, his stickin' glasses), and stumble into the bathroom for a consultation.

Me: Okay, first look at this one. [Brandishes negative test from last cycle. Paul peers owlishly at test.] Now check out this one. [Shoves new test practically up Paul's nose. Time passes. Paul stares, holds it up to the light, squints, does everything but take the fucking thing apart.] See, I think there's something there. I mean, you need to want to see it...but I think there's a second line there.

Paul: [Stares fixedly at test. Stares at the negative. Stares at the new one. Stares some more. And more. For about an hour.] Well... [Pauses for another hour and a half.] I think there's something there...

I spent the rest of the day in the bathroom, staring, boring a hole in the test with the force of my gaze.  The thing practically started to smoke, so powerful was my concentration.  (And, really, nothing says home like the smell of burning pee.)

At 9dpt, I repeated the experiment.  The second line was darker, though still quite faint.

At 10dpt, 5 AM found me once again crouching over a stick.  The second line was darker, clearly visible to the naked eye without too much suspension of disbelief.

No doubt about it.  Positive.

But this morning, 11dpt, something terrible happened.  My friends, I hardly know how to talk about this, so I'll just come out and say it:

I ran out of sticks.

The last two days have terrified and reassured me by dizzying turns.  My pelvis feels very busy — fullness, twinges, and cramping, which could be the earliest signs of pregnancy, or could be the earliest signs of a pregnancy ending.  I'm tired, which could be an indication that I'm very busy on a cellular level, or could be that I haven't slept past 5 AM once in the last week.  And my breasts are the slightest bit tender, which could be the effects of increasing hCG, or could be the consequences of pummeling them hourly to check for soreness.

This could mean anything.

I have enough experience — in fact, we all do — to recognize that a positive HPT doesn't guarantee anything, not even a decent number on a quantitative blood test.  Believe me, of that I am painfully and queasily aware.  I am about five minutes pregnant, the littlest bit, and from here anything could happen.

But just as anything bad could happen at this point, so could anything good.

I wasn't ignoring you

...I was just very busy.

First I had to puncture the local lab director's tires with an icepick when it became clear that the staff had gone home yesterday without making sure my bloodwork results had been faxed correctly to Cornell. They'd been sent to the wrong number.

(But, hey, that's okay. No problem. I can wait to learn the results of my pregnancy test after my fourth fucking IVF. Take your freakin' time. That big label that says STAT is really just a serving suggestion.)

Then I had to tip five pounds of sugar into the gas tank of the customer service representative who sent the results to the wrong number again, despite the fact that the correct number was printed in big bold type on the order itself.

(Sure, anyone could make that mistake. I can totally see how you'd fax the results to the wrong number, even after the patient calls twice to offer gentle encouragement and positive reinforcement, making sure you have the right number. Happens to the best of us, I am sure.)

Then, still not done with my spree of vehicular mayhem, I was obliged to shoulder a tire iron and work a pattern of delicate, lace-like cracks into the windshield of the receptionist at Cornell who wasn't able to give me my results, telling me I needed to wait an hour and a half until the on-call nurses began taking calls. I hated to do it, because she was very kind, but I try to be consistent in my vengeance.

(After all, why should I expect to get straight information about my own medical records in a swift and timely manner? It's not like it's my body or anything. It's not like my medical records are my legal property or anything. Of course they wouldn't want to give results to just any old patient without appropriate vetting and strict adherence to procedure. I could be a terrorist, for God's sake. Only a filthy liberal would expect otherwise. Julie, why do you hate America?)

Then I had to rest. Engineering all this chaos takes it out of a girl.

Now, at last, my agenda is clear and I call tell you that I finally learned this morning that my hCG level is a comfortable — though not extravagant — 107.

My clinic likes to see anything above a 50 at this point; if you clear that threshold they don't do a repeat test for another week. That might be a good thing. It will give my victims time to perform the necessary repairs on their automobiles, so that I might start fresh again next Monday.

Two hands

On the one hand, I couldn't wait to go in for my second hCG test, the one that would reveal whether my levels were increasingly appropriately. "Knowing won't change anything," Paul pointed out with his customary and damnable good sense. But that's not entirely true. If it's good news, knowing will reassure me, inasmuch as anything could right now. And if it's bad news, I would rather have some kind of warning. I'd like to have time to stock up on vodka and Cheetos.

On the other hand, I dawdled this morning as long as I could before heading in to get blood drawn. Once I was at the lab, I hid in the bathroom when they first called my name. And then, once stabbed, I bled as slowly as I could. (Think clotty thoughts. Fibrin. Scaaaaaabs!)

I realized I don't really care to know, after all. I can't really believe the best yet, but neither am I eager to confirm the worst, if it's going to come to pass.

Doubleplusgood

365. A healthy number with a doubling time of around 40 hours. Entirely acceptable. Even — dare I say it? — encouraging.

A modest celebration is in order. Do you think they make prenatal Cheetos?

Still

I'm here, but I'm quiet. I've gone overnight from a woman who can't stop talking to one who can't stop shutting up.

Part of it is that I don't know what to say.

This pregnancy is new enough and precarious enough that it isn't funny yet. I hardly dare to think about it yet, much less make fun of it. I do think about it, in an unintentional daydreamy way, but when I realize I'm doing it I feel a surge of panic, as if suddenly realizing I've done something wrong. (See also: Leaving Chinese porno on my mother's kitchen counter overnight. But I swear there was a perfectly good explanation. It wasn't mine. I swear.)

While I don't have much to laugh about, I know I also have nothing to complain about. When articulate bitching is your stock in trade, what's there to say once you get what you want? Not much. You just sit still, biding your time, afraid to accept your good fortune but not so foolhardy as to question it aloud.

Another part of why I'm quiet is that I don't know how I feel.

It feels churlish to admit this even to myself. I almost can't believe I'm confessing it here, in the face of my friends who would be only too thrilled to be in my position. I'm ashamed of what looks a lot like ingratitude. But the truth, which I occasionally try to tell, is this: I am not as happy as I expected to be.

I've worked and waited. I've wanted this for so long. (It's the baby I truly want, but I am told by reliable sources that those are usually preceded by a pregnancy, so, sure, we'll say I wanted that, too.) So why can't I get happy?

It's the wearing nature of anxiety, which exists at such a constant level that it mutes all other emotions. It's not just the fear of another loss, although that looms large and frequently spikes to stratospheric heights. There's also the deeply ingrained mistrust of my body that doesn't quite allow me to believe I'll manage pregnancy and delivery without mishap. There's the apprehension inherent in facing something new — I don't even know how to be pregnant, to say nothing of how to raise a child into a likeable, happy person who's kind to weaker creatures and votes against the Republican party. And there's the chilling awareness that our lives may soon change dramatically, forever, in the good ways we've hoped for but also in bad ways we can't foresee.

Oh, yeah, hey, have I mentioned the ambivalence?

Those feelings are background, a constant white noise that becomes so familiar it starts to feel like stillness. Beneath it all I know I am happy, somewhere; I know this because I do catch myself dreaming now and then. I just can't easily access the joy I expected to bubble up unbidden.

Finally, I'm quiet because I don't know where I belong.

Since I started treatment I've been that oxymoronic anomaly, a fertile infertile. I've gotten pregnant now after three out of four IVFs. Without a baby to show for it, though, I could still commiserate with women who'd racked up negative after negative; although I hadn't had their kind of disappointments, I'd had my own, and I felt we understood each other.

At the moment I'm uncomfortably aware that a pregnancy sets me apart from the people I care about. I feel your pain because I love you, and because until, oh, two weeks ago, it's been my pain, too, the same agony I've felt for the better part of three years of treatment. But I've been granted a reprieve from the sadness that many of you still face on a relentless daily basis. It's a welcome reprieve, to be sure, but one that makes me uneasy, too. How can I sympathize now without awkwardness? How can I tell my infertile friends, "I know what it's like and I'm sorry," when you could fairly answer, "What you know isn't true anymore"?

I feel out of step with most of my friends. I want to be clear about this: I don't feel guilty, and I don't feel unworthy. But I do feel lonely (excellent company notwithstanding). I've gotten such comfort and pleasure out of experiencing infertility with you that I desperately wish we could all be simultaneously going through the resolution to it together, too.

So if I'm not in synch with my barren pals, where do I fit? I'm pregnant enough to feel like a sudden outsider among the infertile. But I'm also experienced enough to feel deeply reluctant to join a cheerful group of optimists at a similar stage, comparing symptoms and ultrasound measurements.

I am somewhere in between. I'm quiet. I'm still. But still here.

Ducks

I live half an hour from a small city by a big lake. We're there a lot for shopping, dinners out, and visits to the local RE. I love the lake; since the shore is only a few blocks from downtown, we visit it often, watching the boats bobbing in the marina, kids playing in the sand of the tiny man-made beach, and the squadron of mallards who nest in the rocks.

Last summer, on a sunny day when I was about seven weeks pregnant, Paul and I went for an ultrasound. We saw the heartbeat, just as we'd hoped, then went to see the ducks.

Hatching happens late up here; by mid-July the ducklings are still small and downy, entirely dependent on their mothers, staying very close to shore. We watched those tiny ducks for hours, not talking much. But then we didn't need to talk, since we knew each other's thoughts — we were happy, we were hopeful, and we were finally part of the business of life in a way we'd never been.

C'mon: pregnant. Heartbeat. Ducklings. Sunshine. It doesn't get better than that.

Two weeks later, everything was different. We'd lost the heartbeat. It's what we expected; we were prepared. We asked for a D&C.

I could have one that day if I stayed nearby, waiting my turn for an empty OR, so we didn't drive home. We waited downtown, the longest wait of my life.

And of course we watched the ducks. They were two weeks older, a little less downy and a little more assured. They swam farther out from shore and picked fights with each other. When their mothers approached to deliver a disciplinary peck, they tried hard to swim away. We could see their tiny feet churning fast in the clear lake water.

And again, we didn't talk much. Again, there was little to say.

I didn't see the ducks again before winter came in. I thought I would today. We went to town for brunch and shopping. Before we ate, we changed tables at the restaurant to get a better view of a sleeping infant. As we shopped, we slowed (though did not stop) as we passed the baby clothes. Then we split up, agreeing to meet in an hour's time.

As soon as we'd parted, I went to the bathroom and saw that I was spotting.

There was only the faintest tinge of beige on the toilet paper, more staining than spotting, thin and very light in color. I sat in the stall staring at the paper, reminding myself of what I already know: brown blood is old blood, less ominous than red. Many women spot throughout successful pregnancies. Bleeding isn't necessarily a bad sign.

But I also know that blood of any color is never a good sign. I know that about half of the women who experience bleeding will go on to miscarry. I know there's nothing I can do but wait.

So I sat in the stall and I cried for a while. I thought of Melissa, I thought of last year, and I thought of the ducks on the lake.

When Paul and I met once the hour was up, it was chilly and looked like rain. We decided against going down to the shore and came straight home instead.

It feels good to breathe again.

Beta #1, 11 days past transfer: 107

Beta #2, 14 days past transfer: 365
Doubling time: 1.69 days

Beta #3, 18 days past transfer: 3,565
Doubling time: 1.21 days

I think we're in pretty good shape.

Chickens

This morning I was up at 4 AM, awakened by anxiety. My ultrasound was scheduled for 9 AM. You would think with a 5 hour lead-in I'd be able to arrive on time. Ah, but no. I was my customary five minutes late. This worked out well because my clinic was its customary 45 minutes late.

I usually don't read magazines in the waiting room. I am far more interested in what's going on around me. I am an avid spectator of life's rich pageant. Either that or I'm one nosy sonofabitch. You decide.

Today I noticed a couple who were there for a prenatal checkup. The woman was heavily pregnant, sheathed in bicycle shorts that probably fit like a glove — a latex surgical glove — several months ago. Now they were stretched so tightly that the tensile strength of the Lycra was severely compromised; you could practically hear the twists of space-age polymer pinging under the strain as she settled into her chair.

She was also wearing a T-shirt that fit snugly across her abdomen. It was emblazoned with a flaky-looking iron-on that read, "FUTURE BIKER."

I think I will make myself a maternity T-shirt that reads, "SECOND MORTGAGE." With glitter. And perhaps, if I'm feeling kicky, fringe.

Her partner blew his nose noisily into a Kleenex, which he then crumpled and attempted to loft across the room into the wastebasket. That's right, shooting snotty hoops in a doctor's office. I am sorry to report that from his overly ambitious position way outside the key, his shot was a disappointing airball.

...

Paul and I have grown careless. We started this pregnancy with firm resoluteness: we would be cautiously optimistic. We would wait and see. We would take it one day at a time. We would not, under any circumstances, count our chickens before they hatched.

But since my last hCG test, we have become that most dangerous of breeds: we have become reckless and unapologetic chicken-counters.

It began innocuously enough. First we didn't refer to life after February at all. Then, once we'd dared to begin doing so, we were careful to preface our remarks with, "If this pregnancy continues..."

That felt pretty good.

It snowballed after that. Before we knew what was happening we were planning projects, talking about middle names, agreeing that it would be nice to have a baby in winter when it feels good to hibernate. All of a sudden we were acting like we believed everything would be all right.

It's a happier way to live than waiting for disaster. I believe cautious optimism is impossible — undesirable, anyway. Why would I want to deprive myself of hope or love?

...

Everyone has always been kind to me at my local clinic. I feel well cared-for there, despite the visceral terror I feel every time I step off the elevator; although I've gotten very bad news in those examination rooms, I still trust in the good intentions of the people who work there. Every doctor and nurse who passed said hello to me as I waited, greeting me by name. HIPAA or not, I count on that.

When I was alone with the nurse, I confessed about the blood. I'd had only meager faint staining over the last few days, but early this morning I had a single episode of true spotting, dark brown blood on the paper as I wiped. The nurse looked grave and said she'd tell the doctor.

"I'll tell you what I see as soon as I see it," the doctor promised as I lay back on the table. My fear must have been obvious. (Maybe it was my saying I was terrified that tipped him off.) The wand went in. Before it had even been fully inserted, he said, "Singleton intrauterine pregnancy with a yolk sac, sized consistent with dates."

So far everything is fine, aside from the spotting.

A more leisurely look confirmed the presence a nicely shaped gestational sac; a round yolk sac; and a thickening on one side of the yolk sac, the embryonic disc, the part that will become, um, a person. Everything is measuring exactly according to dates.

No reason for the bleeding was evident, though the doctor murmured something vague about a friable cervix. Any unexplained vaginal bleeding during pregnancy is called a threatened abortion. (Shout out to my friends, you habitual spontaneous aborters, you.) The silver lining to all this — for if there is one, I can be counted on to find it — is that with that diagnosis, I can avail myself of all-you-can-eat ultrasounds, and my insurance company won't turn a hair.

"I'll see you tomorrow," I told my doctor. He thought I was joking, but did look a little alarmed when I asked him how much an ultrasound machine would cost.

Threatened patient-turns-to-weeping-blob-of-jelly

I've mentioned before that any unexplained bleeding in pregnancy invokes the diagnosis of threatened abortion. This is an awful term, accurate though it may be — okay, it's no habitual aborter, but it does have a certain je ne sais quoi.

Oh, who am I kidding? Je sais exactement quoi. When my doctor coded my file at the end of my last appointment, he said, rather offhandedly, "Don't freak out, but I'm writing in threatened miscarriage." Did he realize, I wonder, that he was dangerously close to threatened spasmodic-kick-in-the-teeth-from-a-woman-still-in-the-stirrups? Threatened keening-so-otherworldly-it'll-cause-every-patient-within-earshot-to-empty-bladder-uncontrollably? Threatened calling-every-day-tearfully-begging-for-a-repeat-scan?

Because that's where I am at the moment. Every day I don't call and ask for another look is a victory much greater than I can describe, a triumph of my own superhuman willpower over my also superhuman fear and sadness.

"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.

I buckled

Remember the diminishing breast tenderness we absolutely were not going to discuss yesterday? This morning it's decreased even more.

I called and moved my scan up a day. Will update when I can.

All clear

All is well. We saw and heard the heartbeat. Everything is as it should be, exactly.

Why, I knew it all along!

[Running away very fast.]

Thank you all for your unbelievably generous good wishes and expressions of concern. I am honored to furnish your daily jolt of adrenaline.

BUNK. BUNK. BUNK. BUNK.

Because I am a nerd care about sharing this experience with my friends, I will try to show you what the heartbeat looked like today.

We also heard it. Alas, I did not think to take a digital recorder with me to the appointment — a clear indication of poor planning and a lack of dedication, no doubt — so you'll just have to make do with this onomatopoetic representation: BUNK. BUNK. BUNK. BUNK. BUNK. BUNK. BUNK. BUNK. BUNK. BUNK. BUNK. BUNK. Ad infinitum, I hope to God.

At 6w2d you expect the heart rate to be somewhere between 103 and 150 beats per minute, with ideal being about 127. We clocked in at 119. Surprisingly, I am refusing to be concerned about not hitting the mark exactly. It seems that there is a limit to the amount of worrying that even I can do.

Paul's head, my ass

Today's scan revealed that at eight weeks exactly, the embryo has Paul's head — a capacious brainpan suitable for thinking deep thoughts about fascinating topics like Jersey barriers and plastic grocery bags — and my rump — narrow, bony, and singularly unimpressive, suitable only for sitting.

It also has a strong heartbeat and attenuated limb buds. It measured either 7w6d or 8w1d depending on the angle, and it moved while we were watching on the ultrasound. I am pretty sure it is plotting a hostile takeover, just as soon as it manages to grow opposable thumbs. It just has that look about it.

I have been instructed to stop the progesterone injections and released into the great unknown, left to scramble to find an obstetrician. I thought of stopping visibly pregnant women on the street here and asking for recommendations, but it is only too likely they'd say brightly, "Oh! I don't know. I'm planning to give birth squatting over a trench in the woods, presided over by a shaman." And then offer me a really good recipe for placenta helper.

That would be telling

Last summer, I let my grandparents know that Paul and I were having trouble conceiving. Although they haven't been privy to the details of our treatments, they know we've been trying hard, and that we've sought medical help.

When I told my grandfather about this pregnancy, he thought for a minute, cocked his head, and said, in a deadpan voice, "Practice, practice, practice."

...

I have lost control. Now that a few family members know, they'll feel quite free to tell all the others. I didn't anticipate how vulnerable this would make me feel. My grandfather told my uncle, who then called my cousin, who claimed he'd already known, that he was "in the loop." My sister-in-law told my brother before I had a chance to tell him myself. The children will probably be told before I feel entirely comfortable with the idea of them knowing. It's out of my hands entirely.

...

I told family members one by one. I didn't want to make any kind of announcement; at any rate, there was no opportune time to do so since the kids were always around. I told my grandmother when she and I were alone. She teared up, hugged me several times, and wished us well.

I told my grandfather quietly when the room was filled with boisterous activity, leaning close to speak into his ear.

I did not tell my sister-in-law. I didn't have to. I didn't get the opportunity to. As soon as I'd told my grandfather, she rushed over to hug me. How did she know?

She had read my lips from across the noisy room.

Artist's rendering

Some of you have asked for a picture from yesterday's scan. Incredibly, I left the office without one. My memory is imperfect, but because I am eager to share this experience with you all, I have tried to recreate what we saw.

I think it's pretty accurate, though I suspect I may have left out a minor detail or two, like a racing stripe or some fender flames or something.

Note to Paul: Warm the speculum.

I have spent some time considering the question of selecting an obstetrician — more time than the situation strictly warrants, given how few choices I truly have. Here are my options:

• OB/GYN practice affiliated with local hospital. I have something of a history with this practice, since it was they who initially referred me for fertility treatment. They have performed upon me a grand total of two Pap smears, one excruciatingly painful IUI, and one excruciatingly painfuller HSG.

  My doctor of record at this practice is, well, a prick. My last encounter with him was before this last cycle, when I needed some cervical cultures done. He asked a few questions about my treatment thus far; apparently my answers annoyed him because he finally sighed dismissively, rolled his eyes, and said, "You know what? I'm just going to shut up and do the swabs." Do, thought I, bracing myself for the onslaught.

  I object to being treated by him. There are other doctors in the practice and a whole mess of midwives, so I probably shouldn't rule out the entire practice, but since my every encounter with the office staff has been, oh, infuriating, I am not inclined to give them further consideration. They have lost my test results, then failed to send them to other doctors when asked, then refused to give them to me without an immense amount of static. ("No, in fact, the doctor does not have to give his consent for me to have them. They are my property, so go eat a bag of dicks and get me my records.")

  I have, uh, problems with this practice.

  Unfortunately, they seem to be the only game in town. The hospital itself, with which they are affiliated, is approximately ten minutes away from my house. This is an enormous advantage when we consider that I'll be delivering in February in New England. So I mastered my revulsion and called for an appointment.

  They can see me in three weeks. "I wish you'd called earlier," the receptionist said in a regretful but censorious tone as I politely (no, really) marveled about the wait. "I couldn't," I told her calmly (I swear). "I had to make sure another baby hadn't died on me before being released by my RE, you callous whore." (Okay, I exaggerate, but only a little.)

• OB/GYN practice affiliated with hospital 40 miles away. This practice is the home of a doctor who comes highly recommended and who is, I have been given to believe, downright promiscuous with the ultrasound wand. The distance is a concern. Although I am sure Paul is perfectly capable of driving safely at 3 AM in the middle of a blizzard when the road is sheathed in black ice and I am keening hideously next to him —

  Hm.

  However, given the unsatisfying exchange with the local practice, I called for an appointment anyway. "How about tomorrow?" the receptionist asked brightly. "That'll be great," I said happily (no, really).

• Prenatal care and homebirth presided over by Paul. "Maybe you could hurry up and go to med school," I suggested. "No need," he answered enthusiastically. "For prenatal care, how's this? Take your vitamin and put down the vodka bottle." He paused. "And how hard could amnio really be?"

I've been dreading the start of obstetrical care. I am not ready to ask many of the questions that a patient customarily asks — delivery policies, C-section rate, position on inducing labor, et cetera — because I'm still not convinced I'll get that far. It feels like daring the universe, a prideful challenge it won't be able to resist.

Nevertheless, I'll go. I'll pee in a cup, I'll allow myself to be weighed, and, if I'm lucky, I'll see a heartbeat. For all his good intentions, Paul has not yet been able to engineer a homemade ultrasound machine that satisfies my exacting requirements, so I'll have to make do with a board-certified physician.

We'll just see about that.

Last week I met the midwives at the practice 40 miles away. They are a lovely bunch, kind and warm, supportive and reassuring.

I don't think they know what hit them.

Every time one of them would say something like, "You're going to have a baby!" I would feel an irresistible urge (which I did not, therefore, resist) to say something hideously pessimistic in response, like, "We'll just see about that."

"And then in February..." one would start, and I would add, "...If we get that far..."

"By then your baby will be..." one said. "...Not dead, I hope," I finished.

(Okay, I only thought that last one.)

There's no reason to believe that my pregnancy is currently at risk. There's no reason at the moment to think it will be anything but routine. But by the time I left, the nice ladies were tight-lipped and rattled-looking. I think my lousy attitude convinced them that I'm so impossibly broken that I was about to miscarry on the floor right in front of them. I think one of them even called pre-emptively for a bucket and a mop.

On the one hand, I feel awful, alarming them when they were so kind to me. On the other hand, since my obvious mental disturbance convinced them to order an ultrasound earlier than usual, the end may justify the means. Score one for the power of negative thinking.

How'm I doing?

I have a hard time talking about how I'm feeling these days, especially since I know that many of my friends would give anything to be in my situation: pregnant and nearing the end of the first trimester. You'd be happy. You'd be hopeful. You'd trust. Wouldn't you?

I'm not, and I don't.

The feelings alone are hard to contend with. What's almost as hard is the knowledge that it reveals a failure to appreciate my own good fortune, an utter lack of grace. Because I want to be liked, I sometimes try to conceal that. But because I want to be honest, I occasionally come clean.

If you can't stand to hear a pregnant woman complain — and, really, who could blame you? — please read no further.

I'm fine. And I'm not.

Physically, I feel great. I have no nausea, no aches or pains, not even a hint of breast tenderness.

Emotionally, I'm a wreck. How can I be 9w3d pregnant, how can everything still be going well, without any of the above? I have no indication that anything bad has happened. Nor do I have any indication that everything is okay.

The situation is complicated by the fact that I had no physical sign that my last pregnancy was ending; I can't simply assume that no news is good news. The situation is complicated further by the fact that my last pregnancy ended sometime between 8w0d and 8w5d. With a promising scan at 8w0d, but nothing since, how can I know it hasn't happened again?

I'm not much fun to be around these days. I don't daydream. I don't think of names, I don't visit "your pregnancy minute by minute" sites, and I don't even slow down when I near the maternity shops in the mall. Instead I'm consumed by morbid thoughts, bitter memories, and contingency plans for the direst of circumstances.

I cannot visualize myself eventually holding a baby.

I don't think there's much that could make me feel better. I could prevail upon my local RE's office for yet another scan. And it might reassure me, but the relief would be short-lived; I've heard too many stories that end, "...and we'd just seen the heartbeat the day before." At any rate, I'm pretty sure any temporary consolation would be outweighed by my embarrassment at having capitulated to my seething neuroses once again. And a girl has her pride, after all.

Um.

I don't know when this ends. Once I pass the first trimester? Once I feel movement? Once the baby is born, if it's to happen as I don't quite dare to hope?

It has to end sometime, right?

I, Habitrail

Just like Julia, I had a scan yesterday. In case you're not keeping track, she and I share a due date; at the very moment I was enduring some unpleasant medical procedure, she was getting it on with her husband.

That's okay. I had Valium.

The pictures from her scan are much, much better than mine. (The file is large; it may take some time to download.) I assume her doctor has a more advanced ultrasound machine, allowing sharper resolution for a clearer picture. Either that, or my fetus actually is fuzzy and will be born with a snowy pelt of lush white fur.

This would not be entirely surprising, since in this scan the fetus bears a marked resemblance to a hamster.

An active hamster, too — as we watched, it gamboled about in its fluid-filled bubble. Probably rooting around for some fresh cedar chips, worrying at its water bottle, wondering when the hell I'm going to get around to installing an exercise wheel.

Finger up the ass: no extra charge

At last week's scan, a strange thing happened. As I lay on the table being rubbed all over with exotic unguents having my belly gelled up, I realized I wasn't scared and I wasn't excited. I felt only quiet. Patient, almost; calm, certainly — and expectant in the greater sense of the word.

When the midwife had a hard time finding the fetus with the transducer, I wasn't worried, and I didn't panic. Instead I felt this enormous sense of acceptance settle over me. Whatever would be, would be, and I knew I'd somehow be okay with that. I knew that if we didn't see a heartbeat, I would be devastated, of course, but I'd manage. Somehow. Like I have so far. Like all my strong friends have. We don't die from disappointment, much though we might sometimes wish it.

I felt peaceful.

And then we did see the heartbeat, and movement, and I felt excited again, almost elated. That wore off a few days after the scan, but the feeling of peace persisted. It's strange and comforting, and I hope to God it continues. I'm not confident yet. I'm far from fearless. But I've felt weirdly serene in the knowledge that I can take what comes.

...

Today I am ordering my first installment of maternity clothes. Although at 11 weeks it's way too early for me to be showing, I am, thanks to the diabolical complicity of Messrs. Ben and Jerry. I am well aware that the widening of my waist is due entirely to joyous overeating, since the fetus is now a mere 1.8" long. But whatever the reason, my pants are too small, and they'll only get smaller from here.

Starting later this week, you can expect to find me swaddled in some delightful pastel-colored confection, probably topped with a festive satin bow.

Or, bigger jeans.

...

The obstetrician put a gloved hand (or several digits thereof) inside my vagina to look for her lost car keys. Not finding them there, she apparently decided my rectum was the next most likely spot. Only after repeatedly clenching my sphincter failed to produce a telltale jingling did she grudgingly admit she'd probably left them up someone else's ass by mistake.

...

Today the doctor tried to hear the heartbeat with the fetal Doppler, but could hear only my heartbeat. She tried to locate it with a transabdominal scan, but could find nothing. "We'll have to do this the other way," she said.

The other way. The good way.

Again, this feeling of calm. I knew we might have trouble hearing the heartbeat with the Doppler because my uterus is extravagantly retroverted. I wasn't surprised that we couldn't see much with the transabdominal transducer because the nurse had had me empty my bladder. I didn't assume the worst. I lay patiently, splayed, admiring my own serenity, while the doctor sheathed the probe with a lubricious-sounding snap.

And my patience was rewarded.

Heartbeat: strong. Face: one. Head to the left, legs to the right, feet on the end as expected.

I was moved, of course, and thrilled. But more than anything, I wanted to take my child's chin lovingly in my hand — look at me, please, when I'm talking to you — and, in a firm but gentle tone, ask the little bastard where he's put the hamster.

Come February, someone's going to have a hell of a lot of explaining to do.

Back in the saddle stirrups again

I spent the last week at my parents' house. I'd hoped to spend more time with my mother, but between the boisterous presence of my nephews, who live down the street, and the arrival of my aunt, who brought my cousins up for a visit, it was seven days of nonstop chaos, instead of the relaxing interlude I'd imagined — you know, when I was in a heroin-induced fugue state.

Although I managed to sneak off under cover of darkness a couple of times to check in on a handful of blogs, I'm far behind on others, and way behind on correspondence. If you've sent me mail and I haven't responded, please forgive me; if you've asked to be put on the great big list of blogs, please look for an update over the weekend.

...

I am tired. It's the only pregnancy symptom I've had. No morning sickness, no breast tenderness, not even the crippling constipation Tertia has wished upon me. In the first several weeks, the fatigue took the form of sleepiness. Now I'm no longer especially drowsy, but my body tires easily.

I thought it had abated, but this past week found me sitting helplessly on the sofa while my 60-year-old mother and my severely arthritic aunt prepared meals for 12 and shepherded five active children into an activity more productive than racing each other up and down the stairs, over and over and over. "You rest," my mother kept saying, shooing me into a kitchen chair while she unloaded the dishwasher for the third time in a day.

And I did, because I needed to, but, oh! The guilt.

...

I have completed the first trimester. Depending on how you count, I passed that milestone either a week and a half ago, at 12 weeks, when a major developmental phase ends, or yesterday, at 13 weeks 3 days, a third of the total gestational period.

I am supposed to feel home free, or close, but I'm still uncomfortable telling people about my pregnancy. I feel uneasy among the low-grade fuss that ensues, and it's hard to act as enthusiastic as people expect.

If I had to name my feelings, I could not accurately say I'm happy. "Happy" suggests a sunniness that I can't quite summon, an optimism that feels somehow immature given what I know. "Pleased" comes closer. "Relieved" is good, too, having gotten this far. I am pleased and relieved. Replieved.

...

I have convinced my nephews and cousins that Paul and I are going to name the baby Batman.

Nephew 1: What are you going to name the baby, Aunt Julie?
Julie: Well, that's a good question. I was thinking Batman would be a good name. What do you think?
Nephew 1: But what if Uncle Paul doesn't like that name?
Julie: Oh, we've discussed it and we're in agreement.
Paul: Yeah, I think it's a great name.
Nephew 2: Why?
Julie: Because we both admire Batman a lot. He's a hero who spends a lot of time helping others, and I think that's important.

[Silence. Time passes.]

Nephew 2: [Aggrieved and incredulous with a sudden realization.] What if it's a girl?
Julie: Even if it's a girl.
Nephew 2: Oh. [Remains thoughtful for several minutes.]

Little kids are kind of dumb.

...

Yesterday I took a 6:10 AM flight so that I could be back in town for a nuchal translucency scan. This is a detailed ultrasound used to measure the fluid behind the baby's neck. A thicker-than-usual measurement suggests the possibility of Down Syndrome and indicates the need for further diagnostics (if, in fact, you want to know for sure).

The scan took place on the same floor as my local RE's practice. It was the first time I'd been back since my baseline scan at the start of IVF #4, and I felt panicky just pushing the elevator button, returning to the site of so much sadness.

But yesterday I turned right off the elevator instead of left, and sat with a coterie of women in various stages of pregnancy, instead of with women in obvious states of distress. Need I say I did not feel at home?

The scan went beautifully. The nuchal fold measurement was normal. The heart rate was normal. The baby's growth was normal, measuring a few days ahead. We saw fingers waving; two hemispheres of a developing brain; and a spine that could be nothing else, knobbled with tiny vertebrae.

The tech couldn't find my cervix, so she thought I might have placenta previa, in which the placenta completely or partially covers the cervical opening. This is a complication you don't want; it can cause a range of problems from benign vaginal bleeding to preterm labor to — ulp — fetal and maternal death.

Not exactly the words you want to hear when you're flat on your back, jellied to hell.

The tech said she'd like to get a look with a transvaginal ultrasound, and went to show the pictures to the doctor while I emptied my bladder. When she came back, she said the doctor wasn't concerned, and that we'd try again transabdominally. Maybe with an empty bladder, we'd be able to get a better look.

And we were. There was my cervix in all its bendy glory, unthreatened by an encroaching placenta intent on achieving its Manifest Destiny. However, the placenta is still somewhat low-lying, which calls for careful monitoring. Because of this, I should have another scan around 18 weeks.

I should point out that every transabdominal obstetrical scan I've had has featured ultrasound gel brought to a comfortable temperature by an electric warmer. By contrast, every transvaginal scan I had during infertility treatment included a frigid dollop of gel born somewhere high in the tundra of the Rockies, then carefully stored on an Arctic floe.

If you're pregnant, you get nice warm gel lovingly slathered onto your distended belly. If you're infertile, you get an unceremonious poke into a cooter full of permafrost.

Make of that what you will.

Fashion victim

I have learned with relief that one need not give up one's own inimitable personal style when pregnant. There are so many options available, so many looks to choose from.

And contrary to what you might believe, it doesn't even have to cost a lot. Why, for the paltry sum of $14.99 (jeans with imprudently placed faux fading, clearance rack, discount store) plus some timeless classics you already own (husband's roomy-but-grease-stained T-shirt; holey underpants stretched beyond recognition by years of wash and wear) you can look just like you always have, exactly like a hobo.

A bigger, zittier, exhausted-looking hobo. Look for me this fall on the catwalks of Milan.

Home free

I passed some sort of milestone. I am no longer assuming this pregnancy will fail.

I still fear it will. I rehearse in my head what I'd say to my parents. I contemplate asking Paul to go with me for the next live baby check — this afternoon — in case I need him to keep me from collapsing. I shave everything (well, almost everything) on the chance that I'll go straight to the hospital for a D&C.

I recognize that my thoughts are morbid. But they're not doomed. Or not entirely. It's progress.

It may be as far as I get. I am told that as my pregnancy progresses, as I eventually start to feel movement, my confidence will increase. And it may, but at the moment I'm all too aware that no one is ever home free.

Some women see two lines on a home pregnancy test and start picking out names, only to have their period arrive three days later. Some women breathe a sigh of relief when their second hCG test shows appropriate doubling. No heartbeat at 6 weeks. Or at 7. Or at 8. Some women see that heartbeat and jubilantly tell themselves, "Now my risk of miscarriage is less than 3%!" Yeah — now welcome to the lucky 3%. Some women pass the first trimester and think they're in the clear. And then.

We all know the stories. We're never home free. This vulnerability isn't limited to pregnancy — it's true for everyone, everywhere, once there's a child involved. It doesn't end with the arrival. A friend once told me parenthood is "like wearing your heart around on the outside of your body." Anything could happen at anytime, often without warning, usually at random. This is what we have to look forward to, a lifetime's worth.

This awareness is always with me. My own experience informs it, as do the stories of my friends. But where it used to paralyze me, at the moment it comforts me. You can either let the knowledge terrify you or liberate you. Because I am lazy and prefer to be comfortable, I choose the latter.

I'm still scared, but the fear has receded to a point where it's not in the foreground, where I can function, where I can hope, though not presume. I can live like this. It feels all right. There is a weird but welcome ease in knowing, okay, I'm not home free — but I'm also no more doomed than anyone else.

Bush 2004

My pubic hair began the year held uneasily at bay. As I prepared to embark upon a series of IUIs, I trimmed it carefully to a neat length, less concerned about aesthetics than the very real possibility that the ultrasound probe would get irretrievably entangled if I left my pelt to its own fiendish devices. In my nightmares I saw my doctor calling for a hacksaw to free the expensive transducer from the malevolent clutches of my bush. So I trimmed. More properly speaking, I pruned, with my own hacksaw, in the privacy of my bathroom at home.

The garbage collectors charged me extra that week for the additional bag that I left by the curb.

During the months between March and May, however, I allowed my pubes free rein. Unchceked, my pubic hair reverted to its former glory, and a golden age prevailed (well, a dark brown, springy, kind of wiry age).

But, lo, there was to come a great and terrible yanking.

When I returned to New York for May's IVF, I immediately availed myself of one of the pleasures I'd sorely missed since my departure: an eyebrow wax. And as long as I was being partially denuded, I reasoned, why not go for the full treatment? A bikini wax ensued.

My skin is fair. My hair is dark. My bush is unruly, and resents such intrusions. The delicate skin of my upper thighs immediately broke out in angry pink blotches, blotches that did not abate until a heavy, prickly stubble had taken secure hold of the disputed territory.

Upon retrieval and transfer, the doctors took care to wear Kevlar gloves, lest they lose a finger or two to the razor-sharp booby trap that my crotch had now become. I remain convinced that the only reason I don't have twins is because one of the delicate embryos underwent a panicked lysis the moment it was brought into the same room as my deadly, deadly beaver.

And then we waited. My husband kept a respectful and terrified distance, not because of the proscription on sex during the two-week wait, but because...well, have you ever made love to a Garden Weasel?

Since May, my pubic mat has remained unmolested. It has regained its former exuberance and then some. There have been few noticeable changes to my body so far during pregnancy. One of the more alarming is the ferocious imperialism of my bush. Where it used to be confined to a wider-than-normal triangle at the top of my thighs, it has broken free of the arbitrary bonds imposed upon it by my genetic makeup and colonized the rest of my body, hair by single hair.

I now have a few stray hairs, unmistakably pubic in character, here and there on my breasts. I have several below my navel, not the fine down that normally dusts my belly from button to bush, but strong and kinky settlers, digging in, hardy enough to survive the winter. I have three clustered implacably on my inner thigh, at the midpoint between crotch and knee, marshalling their forces, ready to defend their new hold on the motherland.

I am unprepared to stop it from fulfilling its obvious Manifest Destiny. I can only try to hold it in check within the natural borders of my own body, hoping that like 19th-century American expansionism, it can be eventually contained by insurmountable geographic boundaries.

I dare not sit too close to strangers. Who knows what havoc could arise?

Vampire Batman

Julie: pasting from a baby site: Going forward, growth and refinement of your baby's existing systems and organs occurs. Your baby's ears stand out from his or her head. (More or less depending on heredity.) Unique fingerprints and toe prints are developing. Your baby is actually digesting swallowed amniotic fluid. At this time, fat deposits will appear under your baby's skin. This fat will help your baby to regulate his or her temperature after birth.

Paul: mm, fat deposits. cornish game baby.

Julie: Mom may be feeling the baby moving within her but you may not be able to yet. She may yell for you to quickly put your hand on her tummy, but you feel nothing. Don't worry - the baby has nothing against you. They play games very early! Humor mom, place your hand on her tummy and one of these days, you'll feel your little one - and your heart will be stolen forever.

Paul: first it sucks your blood and now it's going to steal my heart?!

Julie: be scared. be very a-scared.

Paul: don't worry. i am.

Rated G (brief nudity implied)

When I was 20, I had what an enamored girlfriend called "perfect maiden breasts." They were round and firm, small but full, and they sat perched atop my ribcage with enviable alertness. At 34B, I needed a bra, barely, but in that size the bras come in gingham, in leopard print, in demi-cups edged with eyelet lace. Frivolity holstered my breasts; matching underpants girded my loins.

And then, when I hit 25 or so, something happened. I grudgingly left my girlish 34Bs behind, assuming a more womanly 36C with ill grace. Goodbye, gingham. Hello, additional hook, you unwelcome bastard. My bras had suddenly become more adult, the kind of bras that pay the phone bill on time and discuss mortgages and health insurance at parties.

And then, around 28, something happened. One day I walked into Nordstrom an overflowing 36C, and left a trussed and cantilevered 38D. Anchoring my rack had become a deadly serious business. Not only did I now merit yet another hook, the shoulder straps now came wide and padded.

For the next few years I held steady, indulging what had become a voracious appetite for expensive foundation garments. But you shouldn't think my bras are fancy. They come in beige and black, period. They sport no lace. They are absolutely plain. And they cost the earth. On any given day, the bra I wear costs more than the sum total of the rest of my outfit. For faultless support, a pleasing shape, and a smooth line under my clothing, I happily pay. I was determined to wear these bras as far into my pregnancy as I possibly could.

And I did. And then something happened. My breasts began to leak out the bottom of my heavily engineered and underwired cups, like overrisen bread dough overflowing its pan. On top, my cleavage was breathtaking. On bottom, half my breast was making a break for it.

This would not do.

Yesterday I went to the maternity shop in the mall and browsed the racks, so to speak. I should have known this mission was doomed to failure when I saw that every single bra, no matter how capacious, had only three hooks at the most. Virtually every bra was composed of light, stretchy cotton instead of the heavily reinforced microfiber I have come to expect. And they cost no more than $15 each, available in white, white, or — if you're feeling racy — white.

I was appropriately wary. But instead of bolting in terror, as my lizard brain told me to do, I explained the problem to the saleswoman.

She was all of 20, with the perfect maiden breasts I left behind lo, those many years ago. (At least someone's using them.) I told her my 38D was no longer sufficient, grievously understating the magnitude of the problem. She suggested I start with a 40E.

Grievously understated. The 40Es were too small.

The magnitude of the problem. The 40Fs were too small.

"I don't suppose you have any Gs?" I called hoarsely from the fitting room, and made her look at me spilling forth from the bra.

"...No," she answered in appalled wonder, a tone I did not especially care for.

Now, one can acquire bras in a 40G; I know this from careful research on the Internet. But they come with frightening words attached, words like "minimizer," "rigid lace," "3-section cup," and "magic lift with back support." They look a lot like this.

Hold me. I'm frightened.

It was obvious that my Ds could do the job no longer. I needed some sort of restraint, so, imperfect fit notwithstanding, I bought what was available. I am now held uneasily in check by flimsy white cotton, ready to burst out of my moorings at the slightest provocation — say, a gentle wafting zephyr of a breeze.

In other words, I am well and truly F'ed.

B-b-bbb-bb-b-b-BAby, you just ain't seen nothin' yet

1. On my vacation, I bought excellent bras, the largest Wacoal makes in my preferred style. I am jettisoning the crappy white cotton Motherhood bras I bought, the ones that don't quite fit. At last I am holstered (and tastefully upholstered) in seamless, stylish comfort. It was worth the forced march I had to endure through the Mall of America. Some things you should know about this tabernacle of commerce:
   
   
   1. It contains approximately five Gap stores, three Victoria's Secret stores, and — get this — one Glamour Shots for Kids. Imagine my surprise: I guess looking like a whored-up airbrushed big-haired hoochie mama isn't just for grown-ups anymore.
   2. It used to have a cereal theme park sponsored by General Mills where you could slide down a giant spoon into a pit of Cheerios. I was bitterly disappointed to learn this had closed, as I had long cherished a dream to wallow in oaty goodness.
   3. There is a Chapel of Love for those romantic souls among you who want to tie the knot between a Lenscrafters and a shop dedicated to selling baseball caps.

   And no, I did not go on the roller coaster, though once I'd acquired my new bras, I am pretty sure my breasts would have weathered the ride with nary an outraged quiver.

2. I am officially nesting. For many women, this entails painting a nursery and lining drawers and folding and refolding tiny baby clothes over and over and over. This is an impossibility for me, because:
   1. the room that will be the nursery — which I have taken to calling "the b-b-bbb-bb-b-b-BABY'sroom," in a panicked stutter — is still serving as Paul's office;
   2. I have purchased no baby furniture and wouldn't line a drawer in it even if I had; and
   3. I have acquired no baby clothes, not a single soft wee garment.

   No, for me, nesting involves a compressor, an air nailer, a random orbit sander, a shop vac, and a pressure washer. The b-b-bbb-bb-b-b-BABY may have to sleep naked in a laundry basket in an empty, dingy room, but if she ever wants to lick the back deck, we'll be golden.

3. I feel movement now. I wish I could say I am filled with awe and wonder, but it's more like horrified fascination. For me, pregnancy continues to be a little bit like watching Mutual of Omaha's Wild Kingdom, where you know the baby seal is gonna get bitten clean in half by the killer whale, but you just can't look away.

   I said a little bit.

   In fact, this utterly natural process of gestation seems strange and almost upsetting to me when I think about it, so I try not to think about it. It should not surprise you that I'm finding all of this somewhat unsettling. After all, you're talking to a woman who is freaked out by eggs, any eggs other than chicken or sturgeon, including and perhaps especially her own. I mean, what could be weirder than having a live creature doing a front giant into a one-and-one half front salto south of the goddamn Equator?

   Wait, don't answer that. In fact, I absolutely forbid you tell me what other disturbing surprises pregnancy has in store for me. I might lose my nerve entirely.

Halfway

I turned 20 weeks on September 20. I am halfway through. Today I had a doctor's appointment, complete with ultrasound, primarily to check the placement of the placenta, which was low-lying as of 13 weeks, but also to look in on Batman and see how she is. (I am giving the pronouns equal time, regardless of what I may or may not know about his or her wee tiny genitalia.)

The good news:

The baby looks dandy. A whole mess of vertebrae, two hemispheres in the brain, assorted kidneys, and enough arms and legs to take it wherever its little four-chambered heart desires, once it has given its umbilical cord — complete with three blood vessels — the slip.

The bad news:

Complete placenta previa. The placenta is completely covering the cervical opening. If it were going to move, it should have started by now. Instead, it seems implacably perched, unlikely to do much locomotion. Even a slime mold can ooze across a forest floor with mucusy abandon, but my placenta remains defiantly stationary.

The best-case scenario is that I'll have amniocentesis at 36 weeks, then undergo a C-section shortly thereafter, delivering safely before my due date with no further complications.

The worst-case scenario is a lot grimmer. We are going to ignore the part about possible maternal death, because LA LA LA LA LA LA LA I AM NOT LISTENING LA LA LA LA LA LA LA LA, and also because it's exceedingly improbable, given that I'll be closely monitored. Instead we'll move to the things that are mostly beyond our control: the possibility that I'll have a freshet of terrifying bleeding, might require hospitalization, could go into premature labor, and might — LA LA LA LA LA LA LA — face a severely premature birth.

The upshot:

I've been told to avoid intercourse, orgasm, and other maneuvers that could cause contractions of the uterus. (This only three days after the first sex we'd had since I left for New York in May. Yeah. Funny. We're laughing our celibate asses off.)

I've also been told to avoid strenuous activity. So far I haven't been milking this pregnancy at all since I've felt perfectly well the whole time, but I'm pretty sure I will immediately begin reclassifying hateful household tasks ("Turning your socks right side out, thereby being forced to touch that skeevy polyester terrycloth part: way strenuous. I spot just thinking of it.") and hiring a phalanx of flunkies to do my bidding.

I don't even know how worried I am or should be. What I do know is that I don't care how this baby gets here — never have — as long as it does, strong and healthy. The C-section doesn't concern me, as I have no romantic attachment to the idea of a natural birth. No, I'm hung up on the live baby part. That's the only part that matters.

Swellegant

My parents were visiting this week, so I haven't been writing much. It is difficult for me to type the word "fuck" when they are within a fifty mile radius, much less in the same room. I will get it out of my system now: fuck fuck fuck fuck fuck fuck fucking fuck.

That is how I'm feeling at the moment. Warning: I am now going to further alienate all of my infertile friends and readers by complaining about this pregnancy. Here goes:

After Tuesday's OB appointment, my mother and I engaged in long conversations about what constituted strenuous activity. We agreed that my digging in the garden was a bad idea — there goes that major renovation I'd planned for the front perennial bed. We surmised that painting rooms, however, would probably be okay, as long as I didn't make it the three-day marathon I normally do. And we were sure that housework was all right, as long as I got Paul to carry the vacuum up the stairs.

Yesterday, after their departure, I called the nurse to confirm my assumptions. How wrong I was, how wrong! I have been forbidden to:

• Vacuum, mop, or scrabble around on my knees, crablike, scrubbing bathtubs;
  
• Lift or carry anything of any significant weight, such as a laundry basket; or
  
• Paint, hang blinds, mount a stepladder, or do anything else useful and handy.

But never fear! I am allowed to:

• Walk;
  
• Climb "a single flight of stairs here and there";
  
• Drive; and
  
• Stand "long enough to prepare a simple meal."

In other words, I am benched. I'm not on bed rest, but I'm also not likely to get much done. My dynamo days are over, at least until I'm no longer pregnant. But you shouldn't think I'm upset on that score. I'm not annoyed by the forced inactivity, because I will do (or not do, as the case may be) everything I can to keep the baby lodged neatly in place for as long as possible. Rather, I'm frightened by the need for it.

...

I told a friend in e-mail that I was forbidden both intercourse and orgasm, asking whether blowjobs would be considered strenuous activity. (Of course the only possible answer to that is, "Yes, if you're doing it right.")

She said, "Nope, no blowjobs. None for me means none for you, bucko."

Now let's just hope Paul doesn't decide that no lifting laundry for me means no lifting laundry for him.

Bucko.

I will say that I have no qualms about Paul's ability to keep the house in good running order (with the help of a few carefully selected professionals — fair's fair). One of Paul's most attractive qualities is his competence. He doesn't vacuum the way I vacuum, but good enough is good enough, and he is cheerful and willing, even better.

There are women who complain that their husbands aren't involved in their pregnancy because they don't exhibit an intense interest in every symptom, don't volunteer to attend every checkup, or don't know the textbook definitions of lanugo, vernix, and meconium. (I think those were the names of the Magi, coincidentally.) I am not troubled by any of this: Paul proves his very great investment by working every day to make our house ready, patting me fondly at frequent intervals, and, now, showing solicitous concern instead of annoyance about my physical limitations.

Surely a little blowjob wouldn't hurt.

...

It was such a nice visit. I was made much of by both parents, especially once my condition proved itself to be more delicate (which I like to pronounce with a long a) than I'd wanted to acknowledge. My mother dug in my garden while I sat in a lawn chair, and cooked about two dozen meals for my freezer. My father helped Paul move some furniture out of the b-b-bbb-bb-b-b-BABY'sroom to make it ready for the painting that now won't happen. They showed their concern in countless concrete ways, bringing me to tears more than once.

My dad stood behind my chair and massaged my shoulders, saying, "I've never had a pregnant daughter before."

I did not ask, "What about the other two times?" It didn't seem appropriate.

I've been thinking of you all, but particularly of some of my friends who are adopting, whose family members haven't yet gotten caught up in the enthusiasm of welcoming a new child. My shy enjoyment of my parents' attention was colored by the awareness that you're missing out on some of the celebration that every family-to-be deserves. It seems so wrong, so sad and wrong.

...

Before my parents arrived, I went on a tear. Not only did I spend two full days on my feet cooking and cleaning; I pressure washed the deck, cleaned out the two-car garage, and mowed the back lawn in preparation. (I didn't mow the front because I ran out of time — there is only so much a girl can do in the span of 72 hours.)

My feet hurt, but I didn't give them much notice; I thought it must be that my soles were tender from standing on hard surfaces for such a long time. It wasn't until I was getting dressed before their arrival that I discovered the problem. My feet and ankles were so swollen that I couldn't put my shoes on. My hands looked like a set of overinflated surgical gloves. And it hurt.

I completely overdid it. On Tuesday the doctor confirmed that I was as plump and juicy as a Christmas turkey, poking my shin and saying, "You're even denting all the way up here." I was denting! (Paul would spend the next few minutes poking me experimentally here and there. I poked him harder in retaliation. We are a fun couple.)

The doctor assured me that since my blood pressure was normal, she wasn't concerned about pre-eclampsia. It was garden variety edema, brought on by nothing more alarming than my own stubborn insistence that I was no different from the slave women who gave birth in the fields, then kept on working — that I was ten kinds of mighty badass, every bit as capable as ever, just pregnant.

But then what could be more alarming than that?

P-Funk

No, not that P-Funk. In my case, the p stands for pregnancy. Also placenta previa. Panic. Prematurity. Please let us all make it through this.

The funk — well, I'm in one. I'm in a bad way. I cry a lot, and easily. During the day, I experience isolated fits of weeping. It's better, however, than the night, when I have long, vivid, literal dreams — in the one that recurs most frequently, I am at the hospital begging to be cared for. My request is refused by a doctor who tells me it's too early, that they couldn't save my baby even if I were admitted, that at this point they wouldn't even try.

Yeah, it's pretty bad.

I know that plenty of women have gone almost to term with placenta previa and delivered perfectly healthy babies via uncomplicated C-section. And plenty more have had a scare or two but ultimately went home with babies who have fourished. At the moment those facts are little consolation, since I can't forget that I've so often been the statistical outlier. Time and again, I beat the odds, in good ways first, then very bad. While I'm no more prone to a bad outcome than most women, I'm shellshocked enough not to be soothed very much by even the most encouraging statistics.

I wasn't entirely easy in this pregnancy to begin with. I'd had no reason to think there was anything wrong, but I worried nonetheless. It's just what we do — we worry for no good reason. We worry, and it's mostly for nothing.

Now I have something to worry about, something concrete and serious and documented by ultrasound. I could tell myself that nothing bad has happened yet, but it doesn't seem to help when I know that now it might.

Placenta previa primer

Introduction

Plenty of you hav