Guard your pregnancy against……. recklessness

I’ve seen many people, particularly gynecologists and obstetricians, marvel at the miracle of birth. When I talk to them they keep telling me how they’re always absolutely amazed at every single woman who pulls through a pregnancy with a healthy baby. When I was a medical student I used to find it odd. I mean why are OBs so mesmerized by babies and successful pregnancies? Surely almost all pregnancies come to fruition, I would tell myself. I would never get the enthusiasm that they showed over a baby being born, as if they expected it to not make it. It really looked like a theatrical performance to me when my OB attendings, even though were tough as nails during labor, would drop all composure and sometimes get as excited as the mother because the baby was “here”. As I would stand at the end of the long labor table I would feel out of place. What am I not getting here? This woman was pregnant and now she has a baby. That is exactly what was supposed to happen, right?

Wrong!

My first child was unplanned and was conceived shortly after we figured out how to make a baby. Some people have read some of my other embarrassing reproductive stories elsewhere. Don’t go looking for them. You are already mothers. Those are for the figurer-outers of the universe. 😄

We were ecstatic at the news of my pregnancy. We were young, carefree,and liked to live life with a certain abandon. (We still would like to, to be honest).

We had our baby girl after an amazing initial seven months and a grueling ending two months of pregnancy. She is the biggest gift that Allah has bestowed me with.

We were so happy after Minha but we wanted to have a big family and since everyone, who had their firsts when we had Minha, was having their second, we decided to use this as our inspiration. We stopped using protection and within days I was pregnant.

My feeling of completeness and happiness was overwhelming. I had never thought that a pregnancy would make me feel so good. I had minimal nausea. I went to see my OB right away. She had helped me through Minha’s very difficult labor and had ultimately done my C section and I trusted her implicitly. She assured me that I was pregnant and that I was approximately seven weeks. Because my cycles were irregular she wanted to do a dating sono. She scheduled me for that in two weeks.

If someone tells you that they had mapped it all out and then had everything fall into place by design and fate, this is an example of it. I was graduating from residency in exactly seven months, which meant that I would’ve had my baby right around graduation. My plan was to then spend a year as a chief resident and spend time with my babies. Or I had thought of taking a hiatus and going to Pakistan for a year and raise them in Pakistan for a year.

The best laid plans!

I was on my cardiology rotation when my pregnancy was confirmed. I used to spend a lot of time in the cardiac catheterization lab. I told my cardiology attending when I started rotation that I was pregnant. He told me to not go inside the catheterization lab at all due to radiation. He was a father of many kids and he told me that I should take care of myself like I have a glass baby and any wrong move would break the baby. My friends and I laughed and laughed at this analogy. We agreed that it was so true. That pregnancies are so precious. But when you’re in your twenties and surrounded by friends who take things as recklessly as you do, these analogies don’t stick with you.

One morning there was a different cardiology attending. He asked me to accompany him to the stress lab. The stress lab was close to the Cath lab and also had other nuclear scans set up there. I resisted but he assured me that I’m in no danger. And to be honest, I was a little bit of a daredevil. I was young and stupid, basically. Not only did I go in, I spent a lot of time in the nuclear lab. That night I vomited and suffered through the whole night. I kept hydrating myself with water and then lemon water and finally ginger ale but the vomiting wouldn’t stop.

I had my ultrasound the next day. There was no heart beat in my nine week old fetus.

I was by myself. The ultrasound technician told me, the radiology resident told me and the radiology attending told me.

I got a cab and came home.

How Adnan and I dealt with it is another heart-wrenching story! How Adnan dealt with it is etched in my brain.

I called my OB. She told me to see her in a week. She assured me that I won’t become septic or infected as the baby is in a sterile fluid sac. She also expected me to go into labor.

I met with her in one week. No signs of labor had occurred. I was scheduled for a DNC.

The DNC happened twenty days after the miscarriage because of OR dates and surgical emergencies. This wasn’t an emergency.

I had a successful DNC. We didn’t know to send the tissue for biopsy but it was fetal tissue. The pregnancy was slightly more advanced than we had thought.

I kept thinking “ why did I go in the stress lab and why did I stay so close to the Cath lab?”

The “why” became huge. And then the “how” took over. May be because I’m a doctor I need to know the reason behind everything to justify its occurrence . Doctors can become very disconnected from the emotion of something by focusing on the reason behind it. I think in my mind the reason was more important. I felt my body failed me and I wanted to know why. My OB kept sending me literature about how first trimester miscarriages are due to chromosomal abnormalities and this is natural selection.

I kept looking for clues to my miscarriage. Nothing mattered to me. I didn’t care where I was I would just open up literature and data and google and try to see if someone’s story matched mine. I couldn’t find any answers.

I met my kind cardiology attending one day and he spontaneously asked me “ Is he kicking now?”. I broke down. He took me in his office and I told him everything. He was very upset with his partner for pushing me. I asked him if he thought the radiation or the stress lab nuclear stuff had anything to do with it. He said he didn’t think so but then he said something that I had thought was so wise but had never really thought of it in depth.

“When a woman is pregnant, all of us need to care for her like she’s carrying a glass baby. It can break if even one of us is not careful. My partner should’ve been careful, not because he has any hand in you miscarrying but because he has put doubts in your head which medical science can’t clear”.

Then he told me I was looking for an answer that hadn’t been formally documented. He advised me to take a break and go away for sometime.

Dear sisters! I don’t want you to live with guilt. I have a lot of guilt. Dr C told me categorically that I shouldn’t go in there but I was like “ this has never been shown to do any harm and my other attending is confident”. That’s my guilt that I didn’t take a precaution, even though unnecessary. But my baby was worth the unnecessary precaution, right? No one will argue with that. I don’t want you to blame yourself.

I don’t want you to expedite labor by following online home solutions. I don’t want you to dilate faster than you can get to the hospital because a certain herb works as a potent cervical dilatory agent and just hasn’t been appraised in medical literature yet. I don’t want you to throw caution to the winds because my pregnancy has been “so healthy so far”. I don’t want you to jump on a yoga ball only to go to the hospital with uterine rupture (if your OB puts you on it in the hospital then that’s in a supervised setting). I don’t want you to have an amniotic fluid embolism because you employed a devil-may-care approach to induction of labor at home. I know the last trimester is brutal. The longing, the wait, the excitement, the anxiety all come to a head. We want to meet our baby as quickly as we can. We want to introduce our baby to everyone. But the baby will come when the baby will come.

May we all have healthy pregnancies and healthy babies. Just remember “ all in good time”. ❤️