Holy Innocents

Today is the day the Church remembers the children massacred by Herod: Rachel weeping for her children.

It is also my due date. It has been an OK day, or even a good day. We're in a posh hotel for a few nights before going away to see the family hordes, and had my mother and mother-in-law for Christmas, so need a break. Today was a museum, shopping, and church. Tomorrow a massage, returning some Christmas presents, and a meal out in the evening; for once I seem to have a more interesting new year planned than most of my friends.

Should I call? Or will it make it worse?

1) Very close friend S (was my best woman) and her husband J - I blogged about this - had a recently failed ICSI cycle. Just got a Christmas card from her best woman R. She has a son about the age our first would have been, and confided she had to have some kind of op (to remove polyps? is that even likely?) and then got pregnant. She is expecting twins. I imagine S knew about R's pregnancy before we did, but she hasn't mentioned it, though this may be because R didn't want her to. Not sure if I should call and see how she's doing in light of this.

2) Friend S at work - adopting from central America - I saw a few days ago that adoptions have been closed from her country - now, I am assuming she knows as the news is a little old, but after she got her referral, no idea how these things work, whether they would just slam the door on everyone, or process people who had got beyond a certain stage, or if the cutoff is in the future. They had originally planned to adopt from China but her husband M is too old, and I told her as soon as I saw the news, they contacted their agency who asked if they'd like to be rushed through, and they said no, they'd switch countries. So I feel like the bearer of bad news/as if I am poking them with a stick reminding them if they already know.

Dilemmas. I would maybe email the second couple before going back to work in January, as I don't know them that well, but a friendly Christmas call to my friends S & J would be appropriate anyway.

(Edited: I just looked up more about the overseas adoption news and it looks like they may have gotten far enough along in the process that they will be OK. But I'm still not sure whether to ask or not)

Just relax(in)

I was intrigued to find, at a small internal conference, a poster by a student in another department at my university, on this link - the possibility that relaxin may be crucial for embryo implantation. I think this is well-known in animal research but it seems they are only just transferring it to humans. Not that relevant to me, but I'm not sure the article would have meant much to me at all if I hadn't had a few pregnancies and/or read up about reproductive physiology a bit.

Anyway I am pretty exhausted after a long haul up to Christmas, and am in theory supposed to be doing some work today, but so far have only answered a few emails and developed period pain and a headache. I'm not sure if I really wanted to be stressed and pregnant again on the anniversary of my first positive pregnancy test and Sproutetta's due date (both the 30th) but I'm not.

It's been 6 cycles since my last pregnancy ended and this is the point at which I started making appointments to see the GP the first time around - and started the blog. I am not sure seeing anyone about fertility is what I want to do at this stage - all the fixable and permanent/structural things, as well as MF, have been ruled out, both medically and by our approximately 6-9 month latency of pregnancy on average. I know I'm ovulating every month as I get very clear progesterone symptoms (actually feeling hot, sore boobs, some cramps). If I didn't have a calendar I would still know when day 21 was. I suppose I could ask for an FSH test but although if it was massively elevated it might make us decide to give up on even trying to get pregnant, we aren't in a position to do anything else in the next year, so we might as well just carry on. I guess I feel OK about this.

I was very weepy yesterday watching Cranford (it's a period drama, based very loosely on some novels by Mrs Gaskell) for some bizarre reason (a small boy with a thirst for literacy but whose father doesn't see the point of books is taken in by a kindly clerk, who dies and leaves him money to go to school and indeed to build a school). Mr Spouse gave me a hug and suggested we steal a small Central American baby when we go to the US. "No-one will notice", he said kindly.

Miscommunication

The other day:
Me: Mmm, hellooooo, are you awake?
Him: What does your meter* say?
Me: Red, why?
Him: Well, that's more complicated, not sure I feel like...
Me: Well, you're a bit late to think about that, we've been ignoring it so far!
Him: Oh, I thought we were paying attention to it...

I apologised the next day for not discussing it with him.
Him: Oh, I just do what you tell me. I don't mind.

You can see why I love him.

More news from the trenches

Recently I have noticed that when I am awake at night worrying, or sitting at my desk trying to think of something to write on a project, or lying on my yoga mat, it is mainly not having a baby that is preoccupying my mind. It is mainly work, or Alien Spouse*'s work, or family arrangements, or what we're doing at the weekend, or the dismal state of repair/tidiness of our house (the last much improved recently actually).

I'm not sure if this is a sign of a lot going on at work, or in other parts of my life, or if my mood has actually improved, or if it's the omega 3s, or having a somewhat less stressed Alien Spouse, but it's quite good. I even heard that one of the admin people at work is expecting a second baby (her first was born two months before our first would have been - so I knew she was pregnant when I wasn't telling people I was), and managed not to cry at my desk later.

In other news, and I am shamefully late with this first one, S at work and her husband have heard they have a referral for a baby in Central America. Fabulous news as they were not sure the programme was even continuing. Very young baby - as it is so rare in the UK to adopt from overseas I have probably already said too much.

Secondly however I got a text from my best woman tonight saying she had a negative test after their first ICSI. "Gutted" obviously, but clearly that doesn't even begin to describe it. I don't know whether to call or leave them to have some space so I think I will text back and suggest she calls if she needs to. I think we are probably lucky that we haven't had to consider that - although it has at times been very frustrating to have month after month of nothing, we've never really had one big cycle that everything was hanging on, nor any reason to believe we can't get pregnant on our own. Having something they can theoretically fix must make it much worse when the fixing doesn't work.

*In preparation for our possible US stay we've been looking up visas - I am a citizen, which seems to make things more complicated, not less. But this makes him an Alien Spouse. I told him to comb his tentacles and hide them under a hat at the interview.

It never rains but it pours...

Sorry for the deluge of posts after the silence! I had been very mysterious about a couple of things before going away but the summary is I'd applied for a job, had a telephone interview while I was away, but didn't get it. I should hear this week whether my work is going to give me a sabbatical but if they don't, although I will be complaining vociferously (there are equal opps issues) that should mean we are staying put and not just doing the training and approval process for foster care, but actually going ahead with some placements, in 2008. If we did go away on sabbatical we'd probably get the training and approval out of the way before we went, but no placements.

I think you need to reconfirm your approval annually, so we'd then need to be reconfirmed when we returned. But that wouldn't be a big deal. And by that time we would probably have decided whether that is our long-term future or whether we want to switch to adoption - but I'd be happy to do the respite foster caring while we went through adoption approval.

If you had never seen or heard of an ultrasound

what would you think of it?

A colleague is starting a research project which will involve giving ultrasounds to pregnant women in a developing country. While there are lots of benefits, I am sure, especially as many of these mothers are at risk of mental health problems and bonding with their baby may help them with this, lots of them are at risk for other things - particularly stillbirth - some of which might be noticed on an ultrasound before they are noticed at birth. Would it be isolating or traumatic to find out something was badly wrong before birth, when you knew other women who'd had a stillbirth or a neonatal death but mainly they had found out after the birth that something was wrong? Would you think the ultrasound had caused the problem?

I've been involved with the consent explanations for this - the information sheet you get when participating in medical research, in this case including an oral explanation - and I've probably had the most ultrasounds of anyone involved on the project, including the British colleague with two children. So I'm gathering my thoughts for further information that the women might need, that we can add to the explanations.

Surprise...

is the name of a two-year-old chimpanzee. She lives with her mother, Katie, in a refuge for orphaned and trafficked chimpanzees. As the refuge area is only theoretically big enough for four chimps to have enough to eat in the wild, and in fact more than 40 live there (they are fed four times daily by their keepers), the females are given contraceptive implants - but, like humans, they don't always work. Hence Surprise. We saw her and the other 40 on their island last Saturday.

All of the other chimps want to care for Surprise, but Katie only lets those who have been nice to her in the past have contact with the baby. Most of the new chimps who come into the refuge are quite young, less than 3 years old (chimps stay with their mother until they are about 12) - usually they are orphaned when their parents are killed, or discovered when someone is trying to sell them as house pets or to a circus - and the other adult chimps also compete to become a foster carer for the new babies. Seems that chimps can also feel childless.

I am of course very interested in primate communication, though, so I'll not have any comments about how very human they are, and how they can TALK you know, TALK. They have some gestures - but according to my data, the ones they develop spontaneously or learn from each other are about the level of a 6 to 7 month-old human infant. If you are at all interested, the difference between the species seems to be mainly due to the human infant's desperate desire to connect with, copy, and attend to the same things as, older humans. Chimps may love each other and they are definitely affectionate but they when they make eye contact it is direct - they don't seem to work out that someone else looking at something means they are paying attention to it, nor therefore to extrapolate that the look-er wants them to pay attention too.

Off

Tomorrow afternoon, to foreign and warm, but probably quite rainy climes - it's the rainy season - Mr Spouse said "ooh, there will be thunderstorms, shall I take a raincoat" and I pointed out that a) he'd just get sweaty and b) that just means lots of rain as that's what tropical rain does.

He has been with me before but it was the dry season. He has just left his increasingly horrible job, the nicest part about it recently being the large redundancy payment, and will be looking for a new one when we get back.

I actually have a post in my head but may not get time to write it tomorrow, so behave yourselves while I'm gone.

Stuck

I have been feeling a little stuck recently - possibly because we are having an enforced break for a month (maybe two), but this has been highlighted by lovely news from three adoption blogs - jennyanydots has been linked with a child and has started visiting Mothercare; and both Jonathan at Life and Times * and Vivien at Getting off the Rollercoaster have been approved to adopt. Meanwhile we haven't been able to sign up for this month's foster carer preparation course as it extends into our overseas trip, and there is so much uncertainty at work. And I feel bad to compare people who have been through such a lot, to where I am now, but can't help feeling perhaps we should have chosen not to keep trying, and we might be there ourselves now.

This might involve longer periods overseas, which would be lovely but which would mean no adoption process for at least two years, or it might mean a move within the UK next year, but moving to a different area could make things harder or easier. We just don't know. If we do go overseas, we might get trained as foster carers and do some caring before we go, or we might not have time. And other things that I would like to do and in fact have told people I will do - like starting a new Brownie group - are having to be on hold, and I can't tell people why, exactly the same as when I was pregnant in the spring.

My mother and one of my many aunts were visiting at the weekend and we were looking at our wedding photos. We saw my grandfather (father of this aunt, but not my mother) and his wife (stepmother that this aunt grew up with) as well as my father-in-law and my friend A, all of whom have died since then, two of them somewhat (in A's case very) before their time. I also saw all the babies and two or three pregnant ladies and remembered that at the time I thought "it will be my turn next". I felt sad. I said it was because of A - and of course, it was, but also for other reasons.

And of course now there are the usual large number of large pregnant ladies around, only now I know that's what I would have been like now, which I am finding Hard. I actually don't feel as sad as I did around this stage two years ago, before my first due date, and although this sounds like I am feeling really negative at the moment, in fact I am surprisingly OK - I am, for a wonder, throwing myself into my work (ignore the timestamp on this... I have almost got my October list of things to do, done, so am giving myself a break) hence lack of commenting on other people's blogs.

We are discussing what to do for Christmas, when I would have been imminently due - my preference is somewhere far, far away or at least private - my due date was Dec 30th officially so I am hoping that concentrating on that particular date will help me get through Christmas, and will mean I can cope with family in the New Year when people seem to be planning a get-together, with my insensitive brother, very busy sister-in-law and noisy nieces.

*blog very general and mainly about software - but there are so few UK adoption blogs, even including the few overseas adoption blogs, that I feel I need to read them all.

Other people's stories

Just for a change.

S, my colleague at work, and her husband, M (however I put those two together if you are British it spells something silly or unfortunate) have been approved for adoption in Guatemala. These are the couple who had only just started when adoption in China was closed to those over 45 (I believe - too young for them anyway). She sounds very tired of the process and not at all excited - the US agency they would go through has just warned them that things may be closing down in Guatemala. They are not sure they would try another country, having initially thought about Russia, then China, they feel this may be the end of the road.

The other S, my best woman, and her husband, J, have an IVF information and planning appointment next week. I am assuming she will be starting downregulation (that's the sniffing, right?) a week later on her next CD1. I think she needs to get on t'internet as I think I know more about it than she does. I say IVF, but it will actually be ICSI - turns out J has low sperm count and motility (I think - perhaps it was poor morphology). She sounds slightly overwhelmed, which is not surprising since they were only told in August that they would need this and could have 2 rounds on the NHS, starting right now as she is 38, though he is a lot younger.

Apparently J's brother also has male factor, and in his case it is not fixable, and has probably contributed to the breakdown of his marriage. Both her sisters-in-law (one each side) are pregnant, one in SE Asia (S: She was a bit worried at the start of the pregnancy, not sure why. Me: Er, malaria? Very bad for babies? Causes miscarriages? S: I thought it was only dangerous after birth. Me: No - mosquitoes like pregnant women, too, because they are warm, and the parasite likes bits of you with lots of small capillaries, like your brain or the placenta. Actually (though I didn't say this) it is a huge risk factor throughout pregnancy).

Went to see Dr Alternative yesterday, who again recommended homeopathy (I had stopped taking it on the grounds that a) I don't believe in it and b) it was making me feel ill). Might not do me any harm to give up coffee again, though. He was even more pleasant this time, though he still harped on IVF, and it still won't increase our chances of pregnancy over what we've managed so far, nor decrease our chances of miscarriage, he was more accepting of our reasons not to do it. He reminded me I need to find a different, less food-Nazi, acupuncturist locally. He also said I looked well, and I think I do feel well. I've had a fairly calm summer, and I actually think some of the supplements might be helping me feel calmer and more productive. If I had to put my finger on it I'd say the omega-3s.

No nothing

Here we have:
No pregnancies, ongoing or otherwise (so Vivien is quite safe here)

No trying to get pregnant, either - Mr Spouse has decided that we will be OK using Persona-as-it-was-intended for the next month. We'll see how he feels after 10 red days...

No foster carer preparation course (it starts before we go away to Foreign Parts but we wouldn't finish it)

No social worker (she was supposed to come round and check our forms, but got held up at work - not complaining - but she didn't call - I think this is common - still, they aren't as bad as workmen, eh?)

No actual tears, yet, but they may be triggered by either my neighbour/workmate bringing her sick baby in to the office as she can't go to nursery and there's a big job on at the moment or the thought that our lovely family house that was supposed to have nappies in the airing cupboard and a new loo under the stairs when they grew into bathroom-hogging teenagers, may never see children, if my pending job application goes anywhere.

Philosophical

I'm not quite sure why we bothered with all that, erm, as Mr Spouse put it, activity, as it's CD1, bang on time, today. Of course I did a small test yesterday, and of course I've been wondering what would happen if I were pregnant. What would have happened was:

• I wouldn't be able to have my travel vaccinations tomorrow
• I would have had to wait to see if I miscarried at 5w again to book our overseas trip
• If I hadn't we wouldn't have been able to go to malarial parts at the end of October
• Mr Spouse would have been very cross as he has arranged for his last day at work to allow this trip
• and to use part of his large redundancy payment for the trip, too - I'm going for work but he's going along for the ride
• Things would have got very complicated with a potential new job application too as
• I have a very very long notice period and although
• I actually am hoping applying for this will nudge my current employers into a possible promotion
• I wouldn't have been able to say anything to either of them and
• if I had moved jobs I wouldn't have got salary-related maternity pay.

I think I may bite the bullet and see if we can't use contraception this month - we go away a week after my next period is due - Mr S will be a lot less stressed after that and a lot more up for late mornings in bed, so it's a good month to waste - and if I get an interview for the new job things won't be clouded by that, though the length of my notice period means I could still be without decent maternity pay, though I'd be unlikely to be without adoption leave as the process takes so long.

But it's scary doing that for a non-medical reason - which is why we haven't since I had a complete meltdown two months after the first miscarriage and Mr Spouse insisted. I feel like I have about 10 eggs left and skipping a month leaves me with 9.

Edit, in response to comment, as it seemed simpler than a v long comment myself, or a whole new post:
I've had four miscarriages, and apart from the most recent one, no pregnancy has effectively developed beyond 6 weeks. This doesn't fit the pattern of an anatomical irregularity, though I'm not completely familiar with this, my understanding is these are usually later first-trimester. My most developed foetus was only just under 8w.

But I've also had: lap & dye, numerous internal scans, and very good care from one of the main research centres in the UK in recurrent miscarriage. RCOG guidelines (medics' version here) suggest that internal scans are just as good as HSG (which I've effectively had, anyway) in diagnosing these.

Seven weird things

Okay, I'll do it!

1. I can speak pretty fluent Swahili (though it's not as good as it used to be)
   
2. I play the bassoon. Though rarely these days.
   
3. I once moved 4 times in a year, and three of the moves were between continents, the fourth being across a whole continent
4. I used to live next door to someone who was on Big Brother 1 - after she was famous. She was actually pretty nice. She had a housewarming party and no slebs were invited - only her real friends.
   
5. As a child, I went to a nursery in a foreign country but only picked up my colours, numbers, and the phrase "That's mine".
6. I'm not allergic to anything except penicillin - but at one point when I was a child we thought I was allergic to marinated artichoke. We couldn't think of anything else I'd never eaten before, and I'd even had steamed artichoke. But I think it was a red herring and I had in fact been in contact with some poison oak*
7. As it's late, I'm going to say, I need a ridiculous amount of sleep - I could probably sleep for 10 hours a night if I had the time to do it, even when not pregnant. So I'm going to go and do that now.

I guess if I have to tag three people... er... people who haven't been tagged, and aren't about to give birth... well, I don't know for sure if they have been but I tag Geohde, Becky and Perceval (let me know in comments if you read that you are tagged and/or did it already, but I'll try and remember to tell you in your comments!)

*nasty plant growing in US West, for my UK readers

How to try to get pregnant

1. Go to the south of France
2. Drink lots of wine
3. Ditto coffee
4. And Diet Coke
   
5. Eat lots of unpasteurised cheese
6. Sit in smoky cafés
7. Climb some steep hills
8. Get dehydrated and spend lots of time obsessing over mucus*
9. Don't wear very many clothes
   
10. Spend lots of time in bed with your husband

I think the only things I've missed are blue cheese and paté.


*I've been having a protracted online argument with a rabid RC type (male of course) over whether natural family planning, relying on identifying mucus production, works because you can't get pregnant if you don't have fertile mucus, and therefore anyone who thinks they have didn't know how to recognise it, or whether it doesn't work because for a lot of people all they get are patches for a day or two, followed by a long, but fertile, gap.

PS I know I've been tagged by May - will do that when I get my breath back.

Sorry but...

a) this isn't really an update and b) this could turn into a bit of a rant.

The very nice and extremely well-informed Aurelia blogged about a variety of things, including some not-very-new (sorry) "news" that there has been an increase in the number of babies removed from their mothers into foster care. Apparently as well as the Torygraph this has also appeared in the Daily Mail and the Times - both noted anti-social-worker papers. Yes, I am a woolly lefty. But I'm also a member of the British public who reeled in shock as we read about how Victoria Climbie fell through the cracks of the system - and yes, how two adoptive parents were accused (but acquitted) of killing their son.

If we become either adoptive parents or foster carers, we will have social workers in our face, mithering us to death. If I carry a baby to term, I will have a health visitor come to the house before the birth, as well as the midwife. If my birth or adoptive child is injured, the hospital will inform at least the health visitor. The HV will also check for signs of antenatal or postnatal depression. I believe this is right.

I do not believe that babies are being "taken for adoption" - I do believe that the childcare system - hospitals, HVs, midwives, social workers - has become a lot more jumpy. It is true that potential adoptive parents would like healthy white babies, but currently the choice is a) adopt a baby with a disability, a non-white baby (and that's pretty hard if you aren't black or mixed race yourself) or adopt an older child or siblings or b) don't adopt at all, what potential adoptive parents want and what they get bear little relationship to each other. Many people I've chatted to online have rung up their local social services to be told "there are no white children under 5" or " we aren't taking adopters on at the moment" (the latter being more or less what our county told us).

Loads of funding DOES go to women to help keep their babies. If we end up fostering that will be our main purpose - to help care for children while they have contact with birth families and the birth families sort their lives out. Where a child is in temporary foster care, it's for their safety, but children aren't placed directly for the adoption in the UK, ever - they are all placed in foster care in order to give the birth families space and time to be better able to care for them. It's only when that can't happen that a permanency plan that doesn't involve birth family is made - I know that this sometimes means that birth parents who later get their lives together do lose a child but for the sake of the child long periods of uncertainty are bad.

Another bizarre dream

I do seem to specialise in these. Last night I dreamt that I got up early and took a pregnancy test, and there were two lines on it but I knew this meant I wasn't pregnant, and I was relieved. Then Rory Gilmore and Logan Huntsberger were having coffee, dressed in 19th century Life and Death Brigade clothes, and they were just finalising their divorce*, following which they went to bed and slept together for the first time**.

Then I woke up, patted Mr Spouse on the hand as he had been sick, and didn't take a pregnancy test: my period is due tomorrow or the next day, I do occasionally take one the day before it's due and not actually based on any symptoms, more based on desperation/mood, but I went on a long walk with my dad, who is staying, today, and I reckoned that ignorance was probably better in this case. It's a Bank Holiday here and the weather was actually OK - neither too hot nor pouring with rain - the latter being typical for this particular Bank Holiday.

Work continues to be actually reasonable - a more satisfying than expected conference last week, some tasks accomplished despite my poor expectations of my own performance - and I'm feeling reasonably upbeat. Probably because we are going on holiday to the South of France on Sunday. Might have something to do with it. Two weeks in Nice.

*I don't think they actually got married in Gilmore Girls, at least if they did I wasn't paying attention, or it was in episodes we haven't got here yet. So don't spoil it if they do.
**I do however remember that they did sleep together.

The roller blind

Giraffe roller blind
Originally uploaded by katiea

I said I'd do a picture - well, here, finally, it is. It looks quite professional but is actually not very straight, and rather wavy. But it charmed my niece.

I am boring

No-one ever lands here having googled anything exciting. Not since the "I am a media tart" post, over a year ago.

Sigh.

Slightly eccentric, and mildly hard of hearing

but very pleasant and normal - that was the social worker, who came for a "chat" last night. She happens to live about 10 minutes walk from us, and the support person who will sort out some of our paperwork lives on the next street. We live in a small town.

I am not going to post masses of detail about interactions with social workers, partly as I know this is not great from the point of view of security. To be honest most of the information about what's involved in the process of being approved as a foster carer or adopter is a) pretty much public domain and b) extremely variable from agency to agency. It's more the kind of answers you "have to give" to be approved that I am going to try and be more cautious about.

Anyway she seemed happy with us, our house, and our motivations - she didn't delve too deeply into our fertility issues, in fact I felt she rather glossed over the miscarriages, but it did prevent me from bursting into tears. It seems unlikely that we'd be doing respite care for real babies, though there are apparently quite a few in foster care, as there's a lot of drug use around even our leafy little city and its bigger run-down seaside neighbour. Under-3s, and especially nursery and primary age, however, seem very possible.

She also agreed with my indignation about my brother and sister-in-law's ideas about bringing up their two (lack of bedtimes and routines especially - the latest however is that the younger one, aged 15 months, is going to be at one set of grandparents' while the older one is at my mum's, for a month, while they are on a course. I have politely suggested they look into the onsite nursery, or a child-minder's, so the younger one doesn't actually forget her parents).

We now have to wait for them to timetable a foster care preparation course. I have to say (I think I have to say a lot of things - it seems to be a phrase I like) that I do think this seems like the right thing for us now, based on the fact that I am not incredibly anxious about the next step, and feeling like I want everything to happen Right Now, nor am I worried about what happens if I get pregnant, or if I don't get pregnant.

Weird

I have a recurring image in my head of the lab extracting tissue to do the genetics testing on Sprout. I keep wondering what it would have looked like, whether it was recognisably a foetus or whether it was all mashed up. If it had been a still-birth I assume they would do a post-mortem and I think that must be very affecting for the pathologists, even if they see lots of them, and I just keep wondering what the geneticists are thinking when they do post-miscarriage tests.

Nothing else to say. Just that.

Sproutetta*

We had our followup appointment with the consultant today and neither the results, nor my reaction to them, were quite what I was expecting. For some reason I thought the foetus was male - and was convinced they'd find a trisomy. In fact the results came back as a normal female. They only test for sex and 5 other chromosomes, but the ones they test for cover 60-70% of trisomies - the others available cost about £1000 per probe to use and even if we'd been asked if we would pay for that, I think the answer would have been no.

I had thought that if we were given this result, I would be completely unconvinced that they had cultured foetal material. But from what he told us about the lab report (that they managed to get material to grow from the "solid" material) then it/he seemed reasonably confident that it was foetal. And he referred me to this study which found less than half of samples were abnormal. I believe the same group also found developmental abnormalities in about 1/3 of specimens but they don't do that analysis at our hospital.

Oddly I feel quite positive about this. I think it might have been rather depressing to be told there was a trisomy, with the increased risk of future trisomies. We are of course assuming that the other miscarriages were major genetic problems, but we've nothing officially on our slate, so to speak. Risk of miscarriage goes up by about 3-6% per subsequent miscarriage, but doesn't seem to be exponential by any means. He's not as convinced as the previous doctor that getting to a heartbeat means we've a better chance in the future, nor (like the pessimists we are) that having tried everything and failed means less chance. Mr. Spouse says he felt that he - like the smiley doctor - feels more than just professionally sympathetic.

I am quite tired, but feel quite positive in a way, even though we are of course assuming the previous miscarriages were chromosomal abnormalities. I think we are prepared to go on trying for the moment - we have agreed to think about a best-before-date, after which we probably won't go on trying, though I'm not sure it would be the age of 46 (their oldest patient to date with a successful delivery).

(*see Wayne and Waynetta)

I have turned into a sensitive flower

in that everything and anything seems to turn my stomach. I don't think it was a chemical pregnancy (my period started today), as I did test and it was negative (Of course I tested! Who do you think I am! Even though I said I wouldn't till my mother, who is busy being a drama queen at our house for a change, left). Perhaps it is the homeopathic medicine. Perhaps I should stop taking it, as it suggests in their leaflet, and start drinking coffee again. Hmmm.

I think it's probably accurate to say that I have rarely been more relieved to have my period, but that does not really convey the very very low amount of relief that conveys. In fact I am desperate to be pregnant and very sad that I'm not.

But for a change I can see some good things about not being pregnant - I really don't want to slow down at work, as for a change I am getting some serious stuff done, not just staring out of the window and surfing t'internet. I think I've lost a little weight (am doing the Paul McKenna trying to eat slowly till you're full, thing, but not the crazy pseudoscience tapping thing, thank you, but I can see the sense of not weighing myself just yet) and it would be good for me to carry that on. I've climbed two more big hills, I don't really feel like starting running again but I actually feel like I have some energy and I do seriously think this is contributing to my relatively good mood, so I don't want to have to stop that either. And I have a few short trips lined up - London this weekend, a conference in Germany in a couple of weeks, and the South of France in September.

But I don't think any of this is enough, sadly, to stop me wanting to get pregnant. If I didn't want to it would be a lot easier.

Bits and pieces

Not a lot going on but:
Got my medicines (finally) from the Alternaclinic. Some homeopathic ones (but it would actually be good for me to give up coffee - I am not convinced about homeopathy, but I did take some when I had a severe stomach problem nearly 15 years ago, and either that or diet helped. But I had already been trying diet for several months at that point), plus a load of supplements - magnesium (which I'm deficient in), B complex (to help absorb the Mg), and calcium for some reason. Apparently I am vastly over-supplemented with folate so as far as I'm concerned, that's OK.

I think my cycles are getting back to normal, as I've had some small end-of-cycle cramps and ditto sore boobs - not uncomfortable, but enough that I'm pretty sure I ovulated this cycle, though I wasn't sure about the last one.

I've been making up the roller blind for the spare/back/whatever bedroom - I may even post a picture if I get round to it - and moving all the single bedding down there, and putting up a surprising number of elephant-themed wall decorations, and I have obtained (from our local equivalent to Freecycle) a waterproof undersheet. So at least my niece will be catered for.

Mr Spouse was threatened with jury duty to coincide with our 6th August hospital appointment, but it has been cancelled. And the social worker is coming round on the evening of the 18th August - unfortunately Mr Spouse's work situation is definitely busy, and possibly precarious*, at the moment, so he can't really work from home, which may mean the social worker gets irritated with post-commuter-train meetings after not very long.

*Don't worry - he has been with the same firm for more years than even a donkey can remember, so would be getting the largest redundancy cheque anyone has ever seen. Which may equally mean they decide he's too expensive to get rid of. They have done this twice already.

Oh, I forgot

I did manage to get to see Dr Alterna-tweed. Although he wasn't actually wearing a tweed waistcoat at the time, which disappointed me.

The consultation was fairly similar to May's, with some helpful parts and some not so helpful. It was pricey, but the Americans renting our flat were paying, and it was the very first private medical consultation we've done in this whole thing, so that's not too bad. He's going to check my blood levels of various micronutrients, which makes sense, as I do know that the theory behind some people having babies with spina bifida despite adequate folate intake is that they don't absorb it. So it would be good to know if all this folate I'm taking is going to the right place. He couldn't find much wrong with me using his twiddly homeopathy machine, although he kept trying to make me admit I had had lots of ear infections as a child - actually it was lots of throat infections but he wasn't having any of that. And he suggested that, er, perhaps eating lots of sugar wasn't such a good idea when I've had borderline high blood sugar.

No, really, those aren't muffins cooling in the kitchen. Honest. Well, OK, perhaps they are, but I climbed a hill today from which you can see Blackpool Tower and there were hundreds of blueberry bushes at the bottom and I had to pick enough for muffins, OK?

But he did irritate me in his assessment of my fertility chances. Of course it is due to my age - well, I'm not arguing with him there, though I would interpret it as a chance effect which all women have some chance of but older women have a greater chance of. However he somewhat bizarrely seemed to think that we were "very fertile" given my age - I count about 6 months per pregnancy, which is the average for all women, and slightly more frequent than the average for my age, but it is very hard to tell if statistics are applicable to 40 year olds who have only been married for 3 years, and not living together for years before that, and hence perhaps a little more, er, active than some other 40-year-olds.

But what really irritated me is that he suggested that IVF might reduce our chance of a miscarriage. There is absolutely no evidence that this might be the case, not a jot - he seemed convinced that "picking the embryos with the best morphology" would reduce the risk of miscarriage. He also thinks that big studies have "too many variables" so even if they show that IVF doesn't reduce the risk, then it might at some clinics. Problem is, if on average over a large number of women - especially if they are at a variety of clinics - there is no reduction in miscarriage (I think even possibly a rise) then if for some women the risk reduces, for others it must increase, and I don't know which side I'd be on.

Incidentally I have read the NEJM PGS article, and although I'm not convinced that it actually shows that PGS makes the outcome worse, it really doesn't improve chances in the case of advanced maternal age. Other bloggers, and commenters, have said that the study was flawed because they "only" checked 4-cell embryos. Actually they only checked embryos that were at least 4 cells, and although I don't know much about embryology, it sounds like they were trying to do a study of "PGS as it is practiced in the real world" i.e. checking embryos that can be checked, i.e. that have reached at least a certain size. So, PGS as it is practiced in the real world is not helpful for achieving pregnancy if you are older, and it is not helpful for unexplained recurrent miscarriage. Once again - and I know none of you were thinking otherwise - there is no point in doing IVF for us.

One of the birthday couples had her own (38th) birthday this week so I rang for an update. They've had all their tests done and are just waiting for results in about 6 weeks. Unfortunately it looks like it might be male factor - her husband's brother is infertile, and incidentally (or perhaps not) his marriage broke up after I believe a matter of months or even weeks. She seems fine with the idea of IVF, and sure that her NHS trust will pay for it (I didn't like to say that I thought it somewhat likely they would try and put her on a waiting list till she was 40 - cynical, me?)

And lastly we got our foster care pack through, we think we are going to apply and hope to get a place on their training course quite soon, and when we have done that finally tell the adoption agency what we are doing. After decorating before we were away I've been re-tidying the "green room" (ex-study/sewing room, current single spare room/sewing room, possible future children's room) and it needs a "window treatment" - I found some batik purple/green giraffe fabric in my fabric mountain, it is very cute but not too childish, so that is going to be made into a blind. My niece (with my mad brother and my slightly less mad mother) is coming to stay next month, so I am billing this as her/her sister's room. If we do foster, there will be a lot of things that we need to buy, but I am oddly excited about possibly needing to buy a waterproof undersheet for this visit.

Yes, I know. Very few people could actually say that.

Something Else

Had a fairly rotten holiday and have come back to a load of Very Urgent emails and a horrible cold. I can't really be bothered to tell you all the details but lots of drains, trains and sniffing.

I think we are now relatively sure that we don't want to give up trying to get pregnant, at least not for the moment. But as I think I have said before we are not sure that going ahead with the adoption process immediately, or hoping that we can get through the approval without another miscarriage, or indeed without another pregnancy, would be such a good idea.

So we are thinking of something else. Respite foster care. Most foster carers have one partner at home full time or at least part time but respite care is mainly weekends/holidays and as an online friend put it, involves having children in your life but having time to be adults too. Some message board enquiries left me a bit confused as some people seemed to be suggesting that, like with adoption, the expectation was that you would both give up work and not be thinking of getting pregnant, but opinions differ, and I had a very positive phone call with our local authority this afternoon. They thought it was fine that we both work, and didn't seem put off by the fact that neither of us have children. They did want to know how big our house is, and what age we were thinking of. I said not teenagers just yet. But perhaps we should be "greedy" and ask for babies!

It seems to take about 3-6 months for approval - even erring on the long side, this is quicker than any estimates for adoption approval, and given our current progress it does sound practical to hope that we'd be able to do some foster care before either deciding finally to give up on getting pregnant and to adopt, or, realistically, before any viable pregnancy. We would need to be approved as adopters separately, it doesn't shorten the process, and it is rare in the UK for foster carers to adopt a child who has been in their care - we know it's not a shortcut. But it would be very good experience if we did want to adopt, and Mr. Spouse likes the idea of being able to give the children back when we are done.

The back bedroom is also now light green (as were my arms last weekend), and my computer has moved out of there; I'm working on moving my sewing stuff out, too. My Persona sticks didn't arrive before we went away on what turned out to be CD1 (about 5w after the ERPC) so I'm going to have another cycle of not really knowing what's happening, but I think I'm OK with that.

The construction of pregnancy

or to be more specific, this last pregnancy.

We always want to give meaning to things, to associate them with what we feel they should be linked to. On a Monday in April we saw our consultant and heard that neither PGD (as we don't have a balanced translocation, and it is flawed anyway) nor PGS (as it is also flawed) would help us. Up until then I had been feeling that although we might have a family, it would not start in our kingsized bed. We then visited the small-but-very-convenient-for-our-London-flat clinic, and they also quite honestly told us they didn't think they could help. It is entirely possible that we then went straight home and conceived Sprout. Either then, or over that weekend.

The previous day, my friend A who was 3 days older than me, and the mother of two under-5s, died. We heard about this on the Sunday and went to her funeral the following Friday, a week before I found out I was pregnant.

I could not help but feel that this last pregnancy was linked to her. At the start I felt that either a) it was her soul coming back [cheesy, I know, and definitely not something I'd normally think) or b) that because she had had a miscarriage previously, it would be her first baby's soul or c) because she had died, this meant the pregnancy was doomed or possibly d) because she had had a successful pregnancy following a miscarriage* then this would be OK.

I didn't think that much about these associations, though obviously a fair bit about A herself, over the weeks of the pregnancy. But now I am thinking about them again. Just thought I'd share that.

In other news, I tried to get an appointment at May's V. Pricey Alternaclinic but they have no spaces for when I am down in London next week, so I will give them a ring after they fail to give me a cancellation, and try to nip down some other time. However, the idea of having a break seems to have gone out of the window. Possibly more on that shortly, but I don't think I'm taking my laptop away with us, so you may have to wait another week.

*In fact, I happen to know they didn't take a break after her nearly-14-week miscarriage and conceived their first daughter immediately.

The construction of childlessness

One of the problems with our particular version of not-being-able-to-have-kids is that everyone we have talked to about it, who is professionally involved with it, has a different construction on it.

Doctors and nurses see recurrent miscarriage, and long gaps between (some) conceptions as a medical problem. They can't explain it in our case, but they do have at least some medical interventions which have some success in getting to a live birth of a child genetically related to us, which is their goal.

Alternative practitioners seem to view it similarly - my previous acupuncturist was very focussed on getting and keeping me pregnant, and not on helping me stay sane. Although I had my first reflexology appointment yesterday, and the therapist seemed more focussed on general wellbeing, helping me relax and work through my grief, which my old acupuncturist was not really - she even said "so, you've had a period" when I miscarried at 5w.

Social workers see it as a social problem. If we are able to give up on the idea of having children that are genetically ours, they will be much more willing to work with us towards their goal of gaining permanent families for children who do not have them.

We have not consulted any psychologists (well, I've consulted myself and some colleagues, and I did see the scary shirt man) but I don't know of any particular school of thought that would direct a decision one way or the other, the main emphasis being on being happier with what is happening in life anyway; in other words, it is constructed as a cognitive problem - if you look on yourself as childless, you will not be satisfied, but if you look on yourself as childfree you might be.

Going back to the alternative practitioners, I am wondering about seeing a different acupuncturist and/or a TCM specialist. I feel in need of at least a short break, so now might be the time for some herbs, if appropriate. Any suggestions in the NW of England, or London, gratefully received.

(I have a little more to post about The Hospital Experience but that one seemed to want to come out now).

Sad

I was feeling overall better today but remembered later - and was again reminded because Mr. Spouse remembered - that we were supposed to be going for our nuchal scan today, which was booked at the 8w scan, so even before the 10w-scan-that-never-happened. For a complicated work-related and season-ticket-related reason he had to buy a return to the same place we get the train to for the hospital, today, even though he wasn't going there.

That is just the kind of thing that makes me come over all sad. He is such a girl.

Next

Next morning - Weds, 30th May - I rang the local hospital to find out if they had a scan time first thing for me, which they didn't, so I rang the specialist hospital and was told that in order to have an ERPC* at that hospital, my scan had to be there, and that they could fit me in at lunchtime for a scan, and it was likely they could then do the ERPC that night. So I packed my bag (forgetting dressing gown, slippers, and earphones to listen to music on my phone) and we set off, ringing the local hospital as we passed it to tell them we weren't coming.

We needed to go to A&E at the specialist hospital but as it is specialist, and the labour ward is elsewhere, it was relatively quick, and I suspect almost everyone there is in for a similar problem. A quick triage and we were sent downstairs for a scan, where the radiographer did a thoroughly decent job including using visual doppler and narrowing in on the chest area, but couldn't find anything resembling a heartbeat. As I posted previously the foetus was much more as I expected in shape - similar to the previous week - and did not look like it had disintegrated, only like it had not grown further - it still had a distinguishable head and body, and measured 7w6d.

Of course we have since racked our brains for anything that might have happened around 5d after our second scan but that particular Tuesday was quite relaxing so, although we know intellectually that it is unlikely anything I did caused the foetus to stop growing, it is helpful to actually feel blame-free too.

Back up to A&E and a few tears were shed while a junior doctor talked us through the options - well, rushed over medical management, didn't mention expectant management, and talked more about surgical management. I mentioned for the first of about five times that we needed analysis of the foetal material. While we were waiting to be allocated a bed someone in the next cubicle was having a very loud doppler with a pregnancy of uncertain gestation, "about 16 weeks".

I had at this point not had anything to eat since 8.30 and no water since midday, before the scan. They found me a bed and at about 4pm confirmed they'd be able to do the ERPC that day, and that I should be able to go home at 10pm, but I decided I didn't want to arrive home woozy at nearly midnight, so Mr. Spouse went and got me a magazine (forgetting chocolate - he was in trouble later) and went home. More waiting, I went down for the op, and eventually came back to the ward and demanded food. I spent most of the rest of the evening demanding more food, and asking to go to the shop to buy chocolate, and not being allowed to go. I think I finished my magazine, and my first book, and checked various things on t'internet on my phone, and dozed off about 10.30 after the other girls on the ward (unidentified serious gynae op, and huge ovarian abscess) had watched the first Big Brother, and the old lady in the next bed (some type of gynae cancer, removed) had started snoring.

I did have my earplugs, but about 4am was woken by an emergency admission, one of those things that actually makes you feel lucky - early 20s, suspected ectopic, very frightened. I tried really hard not to cry too loudly, and read most of my second book, until drugs came round at 6am and I went back to sleep.

Before Mr. Spouse arrived one of the doctors from the miscarriage clinic came to see me, admired my (Paul Frank) pyjama bottoms, and said how sorry (blah blah) she was to hear this, and then totally blew me out of the water by saying how encouraging it was that we had got this far, we had never got this far before, what they are doing must be working, etc. etc. I have to say that I hadn't thought at all that it was encouraging - more along the lines of, they do everything they can and still it doesn't work - but perhaps she is right. Except she isn't really going to just tell us to go away and give up, is she? Or is she? I have since thought that maybe, if there are two problems (rubbish embryos with genetic abnormalities, and an unsupportive environment), if we can sort out the second, then possibly luck will lead us to have a chance with the first, statistically.

We went back home about midday on the Thursday, after they had finally found me some anti-D (as I'm Rh -ve, and this was my first surgical management). The girl in the next bed still hadn't been scanned, and was getting very fed up of being on a drip. I gave her my magazines and commiserated about waiting for a scan when you are nervous.

I spent the next two or three days in a complete haze, mainly in bed ringing down for things to be brought to me, not even really making it onto the laptop. I think those days were more upsetting for Mr. Spouse, with me being so out of it, and his emotions being very raw, but he was at home with me, and very solicitous too I may say.

It's late, and I'm getting over the (ahem) tiredness from yesterday which followed on from the black tie do of the day before, so I will sign off. Probably only one more update installment - Hospital Visit Mark 2.

Incidentally we (as in, our household) don't do Father's Day - something that Mr. Spouse told me when his father was alive, so it's not that he wants to avoid it because of not being a father yet, or because of missing his father who died last year - my own father has never even mentioned it, except possibly to agree with my mother (always wise, at least when she's in the room) when she bemoaned its artificiality when we were children. I don't remember her acknowledging it when her father was alive either - even though she expected something from us on UK Mothering Sunday, and called her own mother on US Mother's Day. So. I haven't commented on it. But Mr. Spouse has been a bit out of sorts today. Though I think it's his Open University assignment, and the same (ahem) tiredness as me, to be honest.

As he's now asleep I'm not going to wake him up and say "oh, were you upset because it's Father's Day and your dad died last year". I'm nice like that.

*Evacuation of Retained Products of Conception. I think in some places they still do D&C as standard, or else a lot of women are told that's what they are getting, as I've seen a lot of people still referring to D&C, even for recent pregnancies. I even saw an online gynae query where the gynae "wasn't familiar with the abbreviation ERPC". But I believe ERPC is best practice now.

In all its gory detail

You realise this is mainly for me, not for you, OK? So feel free to nod off.

Tuesday 29th May, a.m.: After having had a small amount of brown blood (and I mean small - titchy in fact) over the weekend, I rang Liverpool and got Accident & Emergency who said yes, I could come in, they could not promise to scan me that day, but they could check my cervix. I decided to book a G.P. appointment for that day as a quicker way to check if it was closed. My friend J rang, who had the day off and who I'd completely forgotten might come down to see me if she wasn't too tired after being on call. She is a consultant anaesthetist who lives about an hour and a half away from me. This point will become important later. I realised that there was no other day that week for her to come, and at that point was feeling OK, so I asked her to come down that morning and planned to have lunch with her.

After she arrived, I opened my birthday present from her (she is a busy woman!) and that was my last panic-free moment. The paper is, I think, still sitting in the dining room. One part of the present was a blank book and I remember thinking I could put stuff relating to the baby in the book. That is also still sitting there. We decided to walk into town and get lunch, and I nipped to the loo where true panic set in - I found some red blood. I wasn't even sure whether to tell her but decided she'd know what to do. I remember saying "I don't know what to do now". She suggested that I needed to eat (that was a mistake, really as the place we chose to eat took over an hour to serve us some rather mediocre sandwiches - we chose it as it is on the same side of town as the hospital, and there isn't much else out there except my work) and that going to A&E after that would be quicker than waiting for the GP, who probably wouldn't examine my cervix anyway.

So, about 3pm we were in the hospital and after we had refused the medical student trying to put a canula in and the A&E registrar had failed she did it herself. It is very handy having someone bossy and knowledgeable in a hospital, even if she doesn't know as much about fertility/miscarriage as I do - which made me feel slightly better. By 4 we'd been taken up to an examination room in the gynae ward, and finally at about 4.30 I'd been examined, pronounced to be closed, the bleeding had pretty much given up and I and was about to go home feeling much better, with a promise of a scan slot at some time in the morning. J didn't know what they meant by a follicle tracking appointment [which might have been free] nor when I explained I thought it was for the IUI they do at a different local hospital did she know what IUI was. And she didn't know the condoms in the box on the shelf were for TV scans.

We'd been talking about her pregnancy (she didn't find out till she was 19 weeks - she was on the mini-pill and religious about taking it, but had been vomiting - her daughter was just 7 - she is a big lass but although I only saw her after the birth, having not seen her for a few years, I don't think she was that big!) and antenatal testing (she pointed out, quite rightly, that if the baby had a fatal condition I would be wasting six months to a year of my fertility if I didn't terminate early), and everything felt calm.

Then one of the radiographers (I'm assuming - whoever it was, I've never seen him before, and even J who likes her patients unconscious was aghast at his lack of bedside manner) arrived with a portable scanner although I actually felt very calm, and somehow knew it wasn't going to be good, even before he switched much too quickly from an abdominal to a TV scan. The previous scan had been abdominal and very quickly found something - although looking back now I think even if things had been OK he might not have been able to see much since the resolution is very poor on the portable scanner. But I suppose it was probably best for me not to hang on in hope, as in the first pregnancy I had an overnight of hanging on in hope when Mr. Spouse had given up.

On the TV scan the foetus was measuring just 7w - smaller than when we had seen it nearly 2 weeks previously - and he could not see a heartbeat, and the shape was really blobby and not at all foetus-like. I managed to hold it together until J took me home, by which time Mr. Spouse was there, and she went and made a cup of tea while I collapsed, sobbing, into his arms. At this point I was thinking that the foetus had deteriorated into a mass of undifferentiated tissue, and had been partly reabsorbed, and even was wondering if the first miscarriage (empty sac at 10+2) was in fact more advanced than we had previously thought, but had been reabsorbed. I was also feeling even more depressed (personally) than after any previous miscarriage - serious thoughts of self-harm and even suicide), which very much worried Mr. Spouse.

I've known J since we were both 18, but she isn't a very touchy-feely person - I was very touched when she pressed my shoulder before leaving and said "take care of yourself".

We were still promised a full scan the next day, either in an early morning slot or mid-afternoon. I can't really write much more now, but having started the story I think I'm going to have to finish it at some point. Nudge me if you think I have gone off into a deep depression (honestly, I wouldn't be able to write this if I wasn't feeling a whole lot better).

Isn't that what they say about giving birth?

that the only reason people go through it more than once is that you forget how awful it was? I think that must be what has happened to me with each miscarriage. I look at myself from the outside, thinking how other people must see me, and I think that I must seem, to them, who have never experienced it, rather like those who have experienced seven, ten, teens of miscarriages appear to me - slightly crazy and slightly obsessed.

I mean this with no disrespect to those who are in this boat - in some ways I find their stories inspirational - but although I know (either personally or online) several people who have decided that they have had enough of trying to get pregnant, either on their own or with medical help, I am not sure I know of anyone who made that decision after recurrent miscarriage. I have read that once you've done three properly regulated IVF cycles your chances start to drop, but there don't seem to be those statistics for recurrent miscarriages.

But I also feel that, with this 4th or possibly 5th miscarriage, that I have entered the big leagues. I had various blogs on my bloglines list of people who had had 2 or 3 miscarriages, but several of them have recently moved to the "parents" section (one through adoption, but most through carefully monitored pregnancies, just like mine was...). I know there are more people out there, some of them who are being seen at our clinic. I am not sure how much lower our chances are now (I'm guessing about 50% per pregnancy). Like I say, I don't know if our chances are now about the same with each pregnancy, or are exponentially dropping.

I'm just trying to carry on carrying on here, watching TV, avoiding having my mother to stay, eating peanut butter candy (Thalia is fantastic, but thank you to the other people who offered, you are also fantastic), buying shoes, weeping in cafés, arguing with Mr. Spouse and then both of us apologising, avoiding pregnant friends and those with babies (managed two yesterday on the 10 minute walk to and from town). Mr. Spouse says he is trying to be happy for them by thinking that he couldn't possibly wish this on them.

Back home

I was discharged at lunchtime yesterday, and had to take a taxi home (ill-timed out of town meeting for Mr. Spouse - in fact he was slightly grateful they admitted me as he had to leave at an ungodly hour in the morning and was worried about leaving me at home, in pain and bleeding), but actually found that I felt a bit better than even before I started feeling worse, if you get my drift.

However today I had a migraine (haven't had one during any of the pregnancies - I'm guessing it's the hormone crash) and started feeling a lot more emotional. I had a quick trip to the GP - basically for some tea a sick note and sympathy, both of which I got. She even asked how Mr. Spouse was doing, which impressed him. I'm signed off (which here means you are not allowed to go back to work) until the 25th June. There's one more week of term after that (mainly whole-department meetings, which I may cry off and try to catch up with some students) and we are then on holiday for our annual pre-school-holiday-price-hike trip for Mr. Spouse's birthday. I may go back and see her again (instead of my registered, nice-but-male GP). But she'll need to refill her tissue box first. One tissue! How pathetic is that!

I just about made it to the market and managed to buy a few small things and make it home again before my tears won out over my clenched teeth. Mr. Spouse kindly rang work and told them how long I will, provisionally, be away for, I think also leaving the message that I'd been admitted again, to emphasise that I Am Poorly. Very Poorly. I also seem to have failed to set up my email out-of-office message correctly, so I updated that today, and my irate students will at least have some idea when I am coming back.

I may, as I said, write more about all this when I feel up to it, but I just thought I'd reassure you that I am at least alive, and at home. The pain and bleeding are almost gone, though I am rattling with the antibiotics and as zonked as I wish to be on the good painkillers, there was a little fluid on the scan, so no repeat ERPC, and the swab for infection wasn't back yet when I left, but I think they wanted to be on the safe side and dose me up with killer antibiotics.

Oh how nice

I'm in hospital. Again. A lot more bleeding, clots, and some very severe pain led to a trip to the out-of-hours GP service (a lot quicker than A&E), followed by transfer to the gynae ward, where I am currently languishing, waiting for the good painkillers and some antibiotics.

Trivia

There is a young man I know, through message board/blog route (so when I say "know", you realise I haven't met this person) and he, though only in his 20s, has recently lost his wife. There is more to the story, but this is a tragedy of such huge proportions that you don't really need to know more, though I may post a bit at some point. When this happened, I noticed that fairly quickly he started posting about things other than this huge tragedy on his blog, and on the message board.

I thought this was a bit weird, but I think I understand a bit more. I don't feel ready to process or write much about Sprout and how we lost him (for some reason, we have been referring to the baby as "him"), but I need distraction, more than TV/knitting/reading/napping can provide, so I have also been reading, and occasionally posting, about things that I then think "this does not MATTER. Why do I care about this? Why do I care about anything?".

I'm still in a bit of pain, though not unmanageable, hardly any bleeding, though my whole pelvis seems to be objecting in unison, as I've been having a bit of pain on urinating. No heavy bleeding, clots, or fever though so I'm pretty sure I haven't got an infection, still taking the codeine/gin in alternation. My mother sent home-made brownies (and roses, in the same jiffy bag, rose-scented brownies are surprisingly nice), and Mr. Spouse found peanut butter chunky Kit-Kats which aren't quite Reeses, but are still pretty good.

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The anaesthetic has left me tired and groggy, and the painkillers ditto - just one codeine makes me dizzy and sick, though it works, so I have been taking it at night, plus you can alternate it with NSAIDs, and I'm still quite crampy. I think it's been Mr. Spouse who has been feeling more emotional today than me, as apart from an hour or so in the middle of the night in the hospital, I haven't really been seriously crying. I think I need to be able to feel something to be able to feel sad. It is very different to the previous "natural" miscarriages (the first one was medically managed but apart from timing it was similar to a spontaneous loss).

I'm trying to make sure I have what I need for the next week or so at home but I'm also afraid I'm going to go into recovery autopilot, and just do things that pass the time without helping me feel better - I don't know if the things that made me feel better in the past will be the same ones.

Don't know if I'll describe the whole process, just salient bits, or none of it, but not just yet.

Later: Sent Mr. Spouse out for coffee, lemons to put in the G&Ts (don't worry, I won't mix them with codeine), peanut butter, and Reese's peanut butter cups. They don't have peanut butter cups in our Sainsbury's. Do they have them anywhere in the UK? I think this is a mother's-milk craving - before you could get peanut butter over here, my mother used to bring it back when we visited her parents.

In hospital

You won't be too surprised to hear that. We went to the specialist hospital this morning, the scan showed the same, though clearer and easier to say goodbye, somehow, I've had the ERPC, and multiple assurances that there would be analyses. I'm staying in overnight and Mr. Spouse is coming back for me in the morning.

Not good

Although there wasn't much more blood, and the cervix was closed, the portable scanner showed a poorly shaped embryo and they couldn't find a heartbeat. Another scan on the good machine tomorrow but basically, we are battening down the hatches and thinking about our options.

Red

More blood, different colour. My nice doctor friend is over for lunch so after we eat she is taking me to A&E. Just don't want this to happen in public.

No scan today

I just rang the hospital and the nurse said that given how little blood, and that it's brown, it's extremely likely my cervix is closed, though I can come in, or go to my local A&E, to have it checked, but they won't scan me today since I have one booked for Friday. I don't think they are that full up but it actually saves me a decision - I was wimping out of going to potentially bad news on my own, and now I'll still be going with my mum holding my hand.

It is 90 minutes either to drive (and it's not a very straightforward journey) or on two trains and a bus so given the choice between sitting with my feet up mocking my students' exam answers/watching trashy TV, and taking a long and stressful journey, I am fairly happy to have the decision made for me, and to do the latter. Hopefully Sprout will thank me for it.

Where would I be without something to panic about?

I dashed to the loo before an out of town meeting on Friday morning when I discovered the tiniest bit, ever, of light beige mucus in my knickers. This was after a tiring day and a fairly sleepless night, and at the start of a long journey via the city where Mr. Spouse works to my mother's for the weekend. We had promised ourselves a weekend of R&R but I think there was too much of the second R and not enough of the first as I had a larger, but very light beige, bit each morning, once after, erm, straining, and again this morning when it was gloopier and a bit browner. Apart from the first bit whatever there is seems to be mixed with, erm, how to say this, externally introduced mucus. Logically I know that

a) it is brown, in fact most of it is beige, so there is not a lot of blood and whatever is producing it has stopped bleeding

b) apart from the first day, it was all post-activity and perhaps now is the time to lay off

c) it is very very common to have even some red blood and for it not to be a bad sign

d) it could actually be something external to my cervix

e) all the other symptoms are the same, including the nausea (which, though not worse, seems to be more frequent), and although I have a few cramps if I look at each one objectively it is no worse than any I've had so far this pregnancy. I am also a little confused about the cramping as I've had a couple of wicked bouts of indigestion (sorry, mother, it's not your cooking, I just don't seem to be able to do meat at the moment), and bowel cramps can be easy to confuse with other pelvic cramps.

I'm 9w3d today. You will understand where I'm coming from when I tell you that at exactly 10w in my first pregnancy I had something similar (though quite a bit heavier) and although they pronounced my cervix closed, a scan showed only an empty sac. I know it won't be exactly that way this time, but I've always thought that was actually the first warning of a full bleed, and that it was just taking my body some time (in that case, about 4 weeks) to decide to bleed properly.

I tried to ring the Early Pregnancy Unit at the women's hospital as soon as we got home from my mum's this afternoon but, being a bank holiday today, they were closed and I got the emergency number. I imagine that about 25% of their emergencies, statistically, are miscarriages or threatened miscarriages, though, so they should know what they are talking about. She repeated point a) above, told me to take it easy - "no heavy shopping or hoovering" were her words. I'm taking that to mean I shouldn't have gone to the outlet village yesterday, and that confining myself to home for the next 24h, at least, would not be a bad idea. If I have any red blood, I am to go to A&E locally, but like the other hospital, I can't see them being able to scan me before tomorrow, and in fact, probably not even then given their usual timetable. I have my next scan on Friday, but I will also ring the EPU tomorrow and see whether they think an earlier scan would be possible.

Eating for 1.01

Having noticed my trousers get a little tighter, and being unable to escape the fact that I had been, basically, sitting on the sofa and eating for the past couple of weeks, I promised myself that if I made it past the 8w scan I'd weigh myself. I have put on half a stone (3kg for the imperially challenged) - about 3lb of which I reckon is evenly distributed between my boobs.

Now, I am trying really, really hard not to beat myself up about that - I know that much of it is fluid and blood - but I also know that not exercising, and eating too much sweet stuff, is not good for me or the embryo. So, despite being told not to obsess, I have decided to fill in my online food diary for a week or two. It is not good news. I am eating far more than I need to maintain my weight and I am eating too much sugar, not enough protein, and I'm barely making my 5-a-day some days. I know I should not worry about this, and I also realise I am struggling with nausea, but it is hard not to. I'm trying to concentrate on increasing the amount of protein, and eating slightly less sweet stuff to ward off the nausea.

It is very hard to get to the point of not thinking about my weight, after more than three years of mainly thinking about it. Before I lost weight, I was adamant I was fine - it took a failed glucose tolerance test to wake me up, which is partly why I'm now worried, though at the weight I am now I don't have any problems with glucose, I am very worried about gestational diabetes. But I am also catching myself thinking "I don't want to be a huge fat mother". I actually am not that worried about being a huge fat pregnant woman, partly because I can't quite believe I can get that far.

I had mad ideas of carrying on running while pregnant, and although I am almost certainly not going to go there (boobs hurt too much, and I'm exhausted - took a 2 hour nap today - even leaving my foot aside, so unless they magically stopped hurting in my second trimester, it would be a no go) I still feel idle. I'm not a very sporty person, just fairly active, and I don't like being inactive, but I am still a little scared of being too active.

Big grins all round...

Getting your stuff ready to go for a scan, if it's 90 minutes away, is a fine art. First there are knickers you don't mind losing, then enough books (and lightweight enough) to read when you're both dying to pee, and potentially going mad waiting for a decision to be made. Then there's "do I take overnight stuff". I took my contact lens case and toothbrush, as years of travelling experience leads me to have two sponge bags ready packed at all times - the mini one, with the lens and tooth stuff, and the big one, with the soap/shampoo/hairbrush etc.

But in the event my pessimism was not needed. As you can see, all were happy, including the nice doctor (the one I've seen twice before, and Mr. Spouse once, when we were there in January. She was crying that time, in sympathy with us.
Me: I wish they'd wear name badges, so I'd have better chance of remembering her name.
Him: She was.
Me: So what's her name then?
Him: I forget.
We were too busy looking happy, I think.

Anyway we saw and (pretty much immediately) heard the heartbeat, saw a vague shape of embryo, which measures 7w2d but the doctor says not to worry as there's a large margin of error. It measured 11.1mm and clearly just 0.1mm off would be easy to do, but would make at least a couple of days' difference. I reckon I am 7w5 to 7w6 by when I ovulated so I will try not to fret about that. I did give in to temptation and look up my official due date, which should have been December 29th, so I reckon this would be a January delivery, realistically. And we now have about a 90% chance of having one, by my guesstimation.

The radiographer (50-ish, male - I didn't know they made male radiographers) referred to it as a foetus and we were also later directed to the fetal (sic - despite this being the UK) medicine centre so although I think it is technically still an embryo, that also makes it seem a bit more real. The fetal medicine centre visit was to book in for a nuchal translucency scan and combined blood test thingy. We feel that if there is to be not-so-good news, we would like to know sooner, even if we are pretty sure we won't want to do an invasive test, or terminate except in the case of an abnormality incompatible with life (and we also discussed this case). I had been ruminating on this for a few days and it all came out in an incomprehensible rush (rather like the tax information Mr. Spouse was trying to send me to sleep with last night) but I think we are now on the same page. I think we always were, actually. It is partly personal conviction, partly history - at the moment we feel like we would rather have a baby, and child, with some problems than no baby, or child, at all.

So this afternoon we went to the seaside! In fact, to a gorgeous Victorian town which, local legend has it, was visited briefly by Napoleon, and on which he modelled Paris' main streets. Well, that's what they say. For more information, read the hilarious Lancashire, Where Women Die of Love. We had a slightly substandard pub lunch, and then wandered around the continental market, clearly laid on specifically for us, and enjoyed the fine weather, ditto.

Then home, where I have just come off the phone to my mum - who on being told the news, squealed for about five minutes. She is going to come to my next scan (1st June) as Mr. Spouse is getting to the stage where he will have to take unpaid days off to come with me. She was clearly delighted, not only at the news and the invitation to hold my hand, but also at the chance to get out of something her fellow retirees had signed her up for that she didn't fancy. I swear, she's busier than me. She again bent my ear about my brother's parenting skills (or lack thereof - I better measure up to her idealisation of me, is all I can say!), but seemed a bit more positive about them than recently (long story).

I'm just going to remind Mr. Spouse that he said he'd cook something for me, as I need to eat but can't face the kitchen...

Do you have any children?

I've been asked this twice so far this week. The first time was by one of my Brownies - they seem to have just cottoned on to the fact that I am an adult with an independent life (though she did also ask me if I was a student...) and keep asking me if I'm married, "is that a wedding ring", etc. When I said no, she asked "why not?"

I was a bit flustered, and didn't know what to say - to an adult you can just say "it hasn't happened for us" or even (though it's been three years) "give us a chance, we've only just got married", but neither of those will work for a child. Thankfully the other leader saw I was a bit flustered and told her "She's got lots of students" which then meant I could explain that the students kept me really busy, and then of course explain what students were and what I do, and then have an argument with her about whether I would know her cousin, who probably isn't at my institution (there is another, more vocational, university in town too).

The second time was yesterday when I was attempting to find out if my foot was broken. The shower head fell off the wall onto my left foot on Sunday morning and after the swelling went down a bit yesterday morning, it was still very painful (except if I sit on the sofa and elevate it, which is nice), and had a lump in a place where I don't think there should be a lump, and where there isn't one on the other foot. I can't really walk any distance (especially not in shoes) and I can't drive.

Note that I haven't told my GP practice that I'm pregnant yet - I was planning to book in with them next week, if the scan is OK on Friday. The nurse practicioner at the GP practice said that as A&E have a 48 hour cutoff, I should head over there, where in a miraculous five minutes I was seen by a doctor who said "I haven't got X-ray eyes" and since the foot is a long way from the uterus and the dose is low, I should be OK. The radiographer, however, said that she personally would not have an X-ray in the first trimester, and that there were risks, and I told her I'd had miscarriages before (I didn't mention how many); she asked if I had children. When I said no, she replied "Hang on to this one". Which seemed unnecessarily dramatic.

The upshot was that the doctor refused to do anything, and said he couldn't feel a lump. Now I know he probably sees more broken bones in a week than I have, er, hot dinners, but I couldn't help feeling that someone who is an actual broken bone specialist might have been able to find some way round this. I got the impression that if I had pushed them to treat it as if it was broken, they might have put it in plaster. But I've also been told by friends that when they cracked something in their foot, they were just told to strap it up. Mr. Spouse asked if they could ultrasound my foot, but even in my ignorant state I don't think that would work. I am now paranoid that I'm making my foot worse by walking on it, even if it's just round the house. Anyway, assuming all goes well on Friday, we're going to ask about the risks. Unless of course it is magically better by then.

7w

Not much more to say, really. My boobs still feel sore, though slightly less so, but I feel much, much sicker. I need to eat approximately every two hours, though I haven't thrown up yet. One good thing about pregnancy is you can eat as much dried fruit as you want (if you are like me, and love dried fruit) and you don't get the runs (if you are like me, and dried fruit normally gives you the runs). I seem to feel sicker in the afternoons - in the mornings I'm just starving.

I went to yoga today for the first time in three weeks. I am not sure how good an idea this was, since the time before that was about three months previously. Normally I go to yoga every single week, and have been doing so for about six or seven years, with the occasional gap. I have been feeling a little bloated, and some of the bending over postures were a bit uncomfortable. If I was paranoid (me?) I would have worried it was pressing on my uterus but I know it's still well-protected in there. Happily nothing involved lying on my boobs for long periods of time. But I am wondering about saying something to my teacher. She just does it voluntarily, and is very nice, but I don't really want her altering things in an obvious way ("Dr Spouse, you shouldn't do this one").

I've also booked in to have a reflexology session on Tuesday, on the advice of perceval - thanks - I didn't want to go back to my acupuncturist even though I think she's a good therapist, because she is so bossy about meals. I'm supposed to eat rice for breakfast, according to her. Not going to happen.

I think I feel OK about waiting another week for a scan, though I'm starting to get nervous again, and I'm only sleeping well about half the time. I tried to put a couple of drops of lavender on the pillow, and it ended up smelling like an aromatherapist's boudoir.

Work continues to ignore me, or vice versa, or something. It's exam marking season, which is another good excuse not to go near the office, and to watch back-to-back episodes of trash (yes, it really helps me mark exam scripts accurately. Honest). Currently it's season 1 of The O.C. which I have on DVD. I ordered season 6 of Gilmore Girls ages ago from ebay and it hasn't arrived yet (in fact, the vendor sent me another copy, which also hasn't arrived) and I was originally thinking "don't watch too much of The O.C., you might want it post-miscarriage" but now I'm keping Gilmore Girls for that. But I'm also bidding on things from ebay which I might wear to a black tie do scheduled for when I'm 12 weeks, which, at this rate I won't feel like going to if I miscarry before then. Since it seems unlikely I'll be doing that on my own.

Pants

That's the ones I'm wearing, not a comment on life. They are white. I feel I am becoming more calm...

I had a bit of a panic on Monday and a rather stressful day yesterday - well, a stressful couple of hours in the morning - I felt I should ring Personnel and tell them I needed to have my ante-natal appointments counted as such, not sick leave. They initially wanted me to tell my department but that is not going to happen, so after lunch I rang back and they suggested I ask for annual leave and then they can be recoded later. The only difficulty is going to be getting several days' annual leave during term time, but I think I will be vague and only say that I am actually not just working but away from the office, if pressed. As I've said, I don't want to give my boss the chance to open his mouth just yet.

Continuing to use a visualisation/encouragement technique, this week I am urging Sprout to grow villi and limb buds, and shape its cranium correctly. I've also decided for the sake of my sleep and state of mind I need to do some exercise so I'm going to yoga on Friday and went for a 30 minute walk at lunchtime today.

That article

In case you're interested, it's here. A more recent article from a different clinic gives the predictive power of seeing a heartbeat at slightly lower - 82% - but I'm not clear whether they are all idiopathic recurrent miscarriers, or whether they include some with clotting disorders, and likewise it's not clear from the abstract whether they are using "heartrate over X" or just "presence of heartbeat" as the diagnostic factor. Perhaps someone with a subscription (Thalia?) can enlighten.

(Later - I really shouldn't have carried on reading as I just found another article saying the predicitive power is only 71% in over-40s. Excuse me while I go and sit in a hole).

Telling

Traditionally, of course, one does not tell many people in the first trimester that one is pregnant. We have avoided telling people for previous pregnancies - with the first one, I think realising there was a risk of miscarriage, and not wanting people to come back to us at about 20 weeks and ask how it was going. I think we were probably right to do that. With the next two confirmed pregnancies we were obviously more scared of something going wrong, and then it did, so we felt justified.

This time, so many people know that something has been wrong that we are slightly revising our policy. I have told two online communities (including the one that we met through) on the grounds that, I would be telling them if something went wrong, and we would like their thoughts and prayers before that happened. We have also told two of our adoption referees on the grounds that they are probably wondering what's going on with the adoption anyway, and we think we'll tell my mother, and the other two referees, after the 8 week scan, which ever way it goes.

But thinking about the treatment that the clinic is giving me - basically, TLC and ultrasound - and the fact that if recurrent miscarriers aren't getting treatment, it can be the case that no-one except their partner can support them - I wonder if keeping quiet is really the best policy. Perhaps having an aware support system is something that could actually help one's chances?

I'm wondering when is going to be the best time to tell my boss - he only knows I've been ill, not what with, so he doesn't know how scary this pregnancy is. And he can't keep his mouth shut, and I know he'll want to start planning for any potential absence, and I don't want him to do that until I'm 14 weeks (which would coincide with the end of term, which would be bad from his point of view as all helpful parties tend to disperse). But I don't know how much longer I can be regularly irregular in my physical attendance at work, without anyone noticing. And selfishly, if he knew I was pregnant and wanting to nap every afternoon, I might get a lower exam marking load.