(Note: if you make it to the end, I'm asking for some advice. Lay it on me if you can.)
2012 = BHD = the year of the baby, house, dog. That's the plan, right? We were flying ahead with lightning speed. Like, so fast I couldn't even blog. until around 5 pm last night.
Schreeeeech. Halt. Whoa, look at those skid marks.
Over the holidays, we moved to a new agency. Talked, filled out the paperwork. Not too long after that, they sent a profile our way. How about this one? Ding! Ding! Ding! We have a winner! First try! Lovely, sweet, sincere, healthy pregnancies and births, supported by family and friends. Yes, please, can we talk?
And we did. And we liked her and she likes us. And for about 12 hours our hearts filled again with the idea of bringing a baby home with us. It was a wonderful, sleepless night.
And then in the morning, M. said, hey, weren't we also thinking about this and this? Maybe we should explore this before we go any further.... Which resulted in a whole lot of obscenities and cursing and then later, finger-hurting* angry texts from me. WTF, dude? You think of this now???? We are closer than we have ever been (and that's not very close at all) and you want to regroup the wagons and possibly steer in another direction?? W.T.F.
*Have you ever texted so hard you've bruised your fingertips? I'm not even joking.
His question was rational. My response was not. But I was so angry at not being given at least 24 hours to just. be. happy.
We resolved this by saying, ok, if you want to explore some things, go and explore them and come back with a report and a rationale. And he did. and we decided that the path we were on was the path that works best. Phew. Next step, a conversation with a lawyer from the state where our would-be baby mama resides and would be receiving her care.
This is where the oh, eerrrr, hmmmm......comes in.
Our surrogate lives in a state where parenthood is determined on a case by case, county by county, judge by judge basis. Some counties are more conservative than others. Some judges are more comfortable with the concept of surrogacy than others. While a pre-birth order is possible, its not the norm. The surrogate's name is on the birth certificate until orders are in place. Not a problem for M, since he would be genetically linked. Donor eggs....oh hey now, that's a new twist.
One scenario: we would have a great surrogacy experience, be ready to take home a living, breathing child with our surrogate's blessing, only to be forced with coming home and proceeding with a step-parent adoption of our own child.
Are you serious?
While the lawyer we spoke with pretty much does nothing but third party reproduction, adoption, LGBT and family law, was comfortable with most of the judges in the county we'd be dealing with and has many, many birth orders under her belt, there was one thing that she felt she needed to mention - a suit questioning the enforceability of a surrogacy contract that was making its way through the state's appellate courts. Her words: "A bad decision - well that would be a concern for me."
Yes. Us too.
We talked about other options - leaning on the laws of the state where our agency is based, leaning on the laws of our state, which is pretty surro-friendly.
Well, if we're thinking of relying on the laws of our land, does it make sense to add these other variables into the mix? Are we complicating things here? While we really like the agency and the match, we really, really don't like the idea of going through all of this only to have some random person tell us our child is not ours. Well, not mine at least.
Sigh. I think we need to think about finding a surrogate who lives in another state. There feels like too much risk there to feel comfortable.
So where are we now?
We are getting a second opinion from a surrogacy lawyer in our state, someone our clinic had recommended a while back to help us with any contracts we might need. We want to know -
Are we totally overreacting?
Are there just as many unknowns here?
Is this a risk we will face anywhere?
Because if so, we may just choose to forge ahead with this lovely lady. If not, I plan on asking him about his experience with coordinating a surrogacy with someone we find on the boards (because I went there last night, and you know, its not as scary as it once felt) and if we needed help finding a surrogate, is that something he'd be able to help us with? (his website says yes).
Of course, after that conversation, we need to double back with the agency, fill them in, and perhaps ask them to cast their net out again, but darn it, we really like our potential match. Will we have such luck again?
Funny how we haven't even made it to a preliminary doctors appointment with a surrogate yet we are both feeling like old pros.
So, this is what I'd like to know from you:
Are we overreacting?
Re: the bulletin boards. I've found a few women I might like to reach out to to learn a little more about them. What questions do I ask? How much do I share about us? Is it too bold if I just say, "Hi, I'm m. Here's my blog. This is our story?"
What red flags am I looking for? Besides their place of residence, of course.
Showing posts with label complications. Show all posts
Showing posts with label complications. Show all posts
Wednesday, February 1, 2012
Thursday, December 18, 2008
Answers. More Questions. Disciplinary Action.
[or, The Not So Nice Parts of the Birth Story]
A few days after the birth of the girls, it was obvious that there were some unanswered questions that were eating away at me. M. kindly suggested that I, "write them all down. Put them in a notebook to take to the doctors, and don't think about them until we are there."
And that's what I did.
And this morning I pulled them out. The first stop in our back-to-back doctor tour was with the perinatologist who delivered us. He got the brunt of the technical stuff.
First, the easy ones:
Are you mad that I've been walking?
-No.
Can I start to exercise again? Do I have to wait 4 more weeks?
-No. No problem. Resume your regular routine.
Does that mean everything? Do I have any restrictions now?
-[Do you feel ok? yes.] Then Nope. None.
Now, the harder stuff:
Do you still think an infection caused the pre-term labor?
-Hard to say. We know that by the time we saw you [around 3 am Friday morning], the first baby's sac was fully exposed. Her placenta and umbilical cord were infected. We won't be able to pinpoint at what point they became infected.
If there was an external infection, why were there no symptoms? No discharge. No bleeding. No pain while peeing, nothing!
-It is actually quite common for pregnant women to have bladder infections, for example, with no symptoms. What is even more puzzling is that your 19-week scan looked terrific. No issues there. Something must have occurred within the course of those 2 weeks.
Could my weakened immune system and lack of a spleen had anything to do with the cause, spread, increase of infection? Should I have ever stopped taking penicillin on a daily basis (had done so for years after Hodgkins)
-Probably not. Unless you know you have an infection, there's no sense to pump your body full of antibiotics. And you had probably developed a resistance to your dose of penicillin years before you stopped taking it. I see that as a non-issue.
What came first - the infection or the cervix opening? Was the infection made worse by the cervix opening and exposing the sac or did an internal infection cause the cervix to open?
-We honestly do not know. But we do know that we can take preventive measures for both the next time. Trust me. We will be watching you like a hawk.
Is it possible the infection was already there at 19 weeks when I had my scan?
-Yes. It's possible.
Do you see any reason why I would not be able to carry a pregnancy full term? Any hesitation recommending that we try again?
-I see no reason why you couldn't have a healthy and full-term pregnancy next time. We learned a lot. We know what to watch for. Try again when you are ready. We will not lose two in a row.
And here's where it gets dicey:
What are the differences between cramps that are "normal" and ones that should be watched?
-When in doubt, call. Come in. We'll check you out. We'll always err on the side of caution. Especially with twins.
But, we did.
We did call. My doctor's office at 7:30 p.m. that night when cramps became strong and regular. How long apart? About 20 minutes. Any bleeding or discharge? No. The midwife on call told me to relax. Go home. Take a bath. Put my feet up. Call in the morning.
I did that. And the cramps continued. And became more frequent and by the time we could set our watch to them - every 10 minutes - we called again. She told us to head to the hospital. She'd meet us there. That was around 11 p.m.
We were there in minutes. She was not. In fact, we spent the next several hours in a corner stall getting "monitored" as cramps and pain increased, I was urged to give a urine sample (where I am convinced that I could feel the sacs starting to descend) and M. was left pleading to anybody who would listen, "please. I don't want these babies to be born here!"
Medicine to stall the contractions finally arrived and made no difference. The midwife finally arrived, after I had begun to bleed and show a discharge, took one look at my cervix and said, "you are fully dilated. I can see a sac. Your chances of delivery are very high."
And that is when my doctor was called. He was there in less than 15 minutes and had already called the perinatologist en route. They were in our room before we we were.
So, do you think that timing could have made the difference?
-It is possible.
If we had arrived earlier? If we had been seen earlier? Could any of this changed the outcome?
-We cannot say for sure. It could have been dicey either way. But yes, perhaps, with more time, we could have at least had a better chance of saving the second baby. how much time, that's hard to say. This is where you start to play the guessing game. I can't tell you when the tipping point would have been.
***
If time could have made a difference, how much time did we lose when the midwife told me to "go home and take a bath and relax" at 7:30 pm? How much more time did we lose when we lingered in a corner stall in labor and delivery being "monitored" and nothing else until hours after we arrived?
***
When we got to my obstetrician's office (just down the hall), we learned that he, too, had those same questions. While he didn't say anything at the time, he told us now that when he arrived at the hospital he was very bothered by the fact there had been communication with the office earlier in the day, that there had been such a lapse between our initial voiced concerns and when he was actually called. And that we weren't told to come in and be examined immediately.
We talked with him for a long time. He said there were two questions: "what could have been done to prevent the premature birth?" and "was the best possible care provided and all steps taken at every level?" While we don't have definite answers for the first, he said that in his mind, the answer to the second was no. And that he was going to do everything possible to remedy that. He refused to put his family name on a practice that delivered sub-standard care. You trust people to be on call and be a representative to your practice. In his mind, this was a deal-breaker.
We spent the next several minutes with the HR Director of the office trying to get down an exact time line of what happened and where, in our opinions, there were gaps in care. I don't know what will happen to this account, or what will happen to the midwife who shouldn't be. I am trying not to.
I know that this morning opened up a lot of wounds for M. That he had already come to the conclusions that he could best live with, and that some of the answers we received put those in question. I also know that I needed to hear answers. I needed plain, unsugared explanations. And I needed to know if there were points along the way where I was at fault.
I don't know if a few more hours (few more days?) would have saved my girls. I don't know if Isobel was destined not to be here from the beginning. I don't know if Jovita would have had a chance if we had bought her more time. I don't know. I won't know.
[Updated: I actually just received a call from the perinatologist to clarify: a few hours probably would not have made a difference, especially since my white blood cell count was so sky high by the time they saw me. A day, maybe. But even then there is no way to know.]
A few days after the birth of the girls, it was obvious that there were some unanswered questions that were eating away at me. M. kindly suggested that I, "write them all down. Put them in a notebook to take to the doctors, and don't think about them until we are there."
And that's what I did.
And this morning I pulled them out. The first stop in our back-to-back doctor tour was with the perinatologist who delivered us. He got the brunt of the technical stuff.
First, the easy ones:
Are you mad that I've been walking?
-No.
Can I start to exercise again? Do I have to wait 4 more weeks?
-No. No problem. Resume your regular routine.
Does that mean everything? Do I have any restrictions now?
-[Do you feel ok? yes.] Then Nope. None.
Now, the harder stuff:
Do you still think an infection caused the pre-term labor?
-Hard to say. We know that by the time we saw you [around 3 am Friday morning], the first baby's sac was fully exposed. Her placenta and umbilical cord were infected. We won't be able to pinpoint at what point they became infected.
If there was an external infection, why were there no symptoms? No discharge. No bleeding. No pain while peeing, nothing!
-It is actually quite common for pregnant women to have bladder infections, for example, with no symptoms. What is even more puzzling is that your 19-week scan looked terrific. No issues there. Something must have occurred within the course of those 2 weeks.
Could my weakened immune system and lack of a spleen had anything to do with the cause, spread, increase of infection? Should I have ever stopped taking penicillin on a daily basis (had done so for years after Hodgkins)
-Probably not. Unless you know you have an infection, there's no sense to pump your body full of antibiotics. And you had probably developed a resistance to your dose of penicillin years before you stopped taking it. I see that as a non-issue.
What came first - the infection or the cervix opening? Was the infection made worse by the cervix opening and exposing the sac or did an internal infection cause the cervix to open?
-We honestly do not know. But we do know that we can take preventive measures for both the next time. Trust me. We will be watching you like a hawk.
Is it possible the infection was already there at 19 weeks when I had my scan?
-Yes. It's possible.
Do you see any reason why I would not be able to carry a pregnancy full term? Any hesitation recommending that we try again?
-I see no reason why you couldn't have a healthy and full-term pregnancy next time. We learned a lot. We know what to watch for. Try again when you are ready. We will not lose two in a row.
And here's where it gets dicey:
What are the differences between cramps that are "normal" and ones that should be watched?
-When in doubt, call. Come in. We'll check you out. We'll always err on the side of caution. Especially with twins.
But, we did.
We did call. My doctor's office at 7:30 p.m. that night when cramps became strong and regular. How long apart? About 20 minutes. Any bleeding or discharge? No. The midwife on call told me to relax. Go home. Take a bath. Put my feet up. Call in the morning.
I did that. And the cramps continued. And became more frequent and by the time we could set our watch to them - every 10 minutes - we called again. She told us to head to the hospital. She'd meet us there. That was around 11 p.m.
We were there in minutes. She was not. In fact, we spent the next several hours in a corner stall getting "monitored" as cramps and pain increased, I was urged to give a urine sample (where I am convinced that I could feel the sacs starting to descend) and M. was left pleading to anybody who would listen, "please. I don't want these babies to be born here!"
Medicine to stall the contractions finally arrived and made no difference. The midwife finally arrived, after I had begun to bleed and show a discharge, took one look at my cervix and said, "you are fully dilated. I can see a sac. Your chances of delivery are very high."
And that is when my doctor was called. He was there in less than 15 minutes and had already called the perinatologist en route. They were in our room before we we were.
So, do you think that timing could have made the difference?
-It is possible.
If we had arrived earlier? If we had been seen earlier? Could any of this changed the outcome?
-We cannot say for sure. It could have been dicey either way. But yes, perhaps, with more time, we could have at least had a better chance of saving the second baby. how much time, that's hard to say. This is where you start to play the guessing game. I can't tell you when the tipping point would have been.
***
If time could have made a difference, how much time did we lose when the midwife told me to "go home and take a bath and relax" at 7:30 pm? How much more time did we lose when we lingered in a corner stall in labor and delivery being "monitored" and nothing else until hours after we arrived?
***
When we got to my obstetrician's office (just down the hall), we learned that he, too, had those same questions. While he didn't say anything at the time, he told us now that when he arrived at the hospital he was very bothered by the fact there had been communication with the office earlier in the day, that there had been such a lapse between our initial voiced concerns and when he was actually called. And that we weren't told to come in and be examined immediately.
We talked with him for a long time. He said there were two questions: "what could have been done to prevent the premature birth?" and "was the best possible care provided and all steps taken at every level?" While we don't have definite answers for the first, he said that in his mind, the answer to the second was no. And that he was going to do everything possible to remedy that. He refused to put his family name on a practice that delivered sub-standard care. You trust people to be on call and be a representative to your practice. In his mind, this was a deal-breaker.
We spent the next several minutes with the HR Director of the office trying to get down an exact time line of what happened and where, in our opinions, there were gaps in care. I don't know what will happen to this account, or what will happen to the midwife who shouldn't be. I am trying not to.
I know that this morning opened up a lot of wounds for M. That he had already come to the conclusions that he could best live with, and that some of the answers we received put those in question. I also know that I needed to hear answers. I needed plain, unsugared explanations. And I needed to know if there were points along the way where I was at fault.
I don't know if a few more hours (few more days?) would have saved my girls. I don't know if Isobel was destined not to be here from the beginning. I don't know if Jovita would have had a chance if we had bought her more time. I don't know. I won't know.
[Updated: I actually just received a call from the perinatologist to clarify: a few hours probably would not have made a difference, especially since my white blood cell count was so sky high by the time they saw me. A day, maybe. But even then there is no way to know.]
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