Confessions of an Anxious Mama: Pregnancy After Loss Edition III

30 weeks: she's weighing in at 3 lb 2 oz and is the estimated size of a cantaloupe.

I feel like this pregnancy is flying by. I didn't think it would entering a Pregnancy After Loss and all that comes with it, but just like that, we are now a few weeks into the third trimester. At the 28 week appointment, we sat down with my doctor, like we have at 7 weeks and at 14 weeks, to plan out what this specific trimester is going to look like for us. We've had the 30,000 foot view of what the pregnancy would look like as a high risk classification in general. As many other high risk mamas who I've come to know and because I've had a cord accident, my doctor plans to always induce as early as 37 to 38 weeks. For us specifically, the reason for that is due to the fact that cord accidents are more likely to happen later in a third trimester when baby is running out of room and you are at risk of having a cord accident again if you have already had one. I'll go into more detail on that below. So when I talk about my anxiety surrounding this pregnancy, yes it partially stems from a third trimester loss from the only pregnancy experience I know, but also from this chance of history repeating itself with another cord accident.

If I'm being completely transparent, I really love being pregnant. I love the basketball belly that sticks out of my clothes. I love when it starts dancing around when she moves. I love when my husband leans down and talks to her just because. I love when my dog rests his head on it. I love after every time I wake up in the middle of the night to relieve my bladder, she starts wiggling around and the lack of sleep I get because I don't want to feel her stop moving. I love feeling her within thirty minutes of having food. I appreciate every pound gained, the swollen legs and feet, the cracked heels. I'm exhausted easily, the pressure of her can be a little uncomfortable when walking and standing, my back doesn't feel so great, there are times I think I just burped up a fire ball, times I feel cranky or overly emotional, but - I love it. I'll take it all, all the time, to be able to have it, as many times as I'm able to have it, because I honestly love every bit of it. However, it is difficult when what you love is encapsulated by risk and fear.

For the majority of my pregnancy, I feel like I have been pretty good to my heart and my mind. I have stayed away from WebMD and all things Google in an active effort for calm and peace, trying to disbar the what if thoughts from my mind. However, since entering the third trimester and becoming closer to that doomsday mark (the 32/33 week point), I kind of accidentally, may have slipped on avoiding the world wide web and what it says about cord accidents. It started out so innocently. A special person in my life did something to garner a naming right for Hudson at a large annual conference for medical professionals and individuals in bereavement care for pregnancy and infant loss. They sent me the speaker information and asked me to look at the different sessions and choose which resonated most. There were two talks specific to stillbirth and so I decided to research the speakers and what their messages are in stillbirth research, and see what they say about cord accidents as well. In doing so, I got a little carried away and before I knew it, I was falling down the rabbit hole. 

I have met a number of other mamas living in this Life after Loss world, but I've only been put in contact with one who experienced a cord accident as well. As she was going through her Pregnancy After Loss, she had told me about the Pregnancy Institute, a non-profit organization lead by OB/GYN Dr. Jason Collins, who is a national leader in cord accident research. Last summer, I read a bunch of his findings and studies, in addition to others out there, but his were the most dedicated to strictly this type of stillbirth cause. Jumping forward to the present, while conducting this recent google search, I came across his name again and found myself re-reading Dr. Collins' research on cord accidents. This time I was reading with a different perspective, honing in on the findings of what it can mean for subsequent pregnancies. My inner Jiminy Cricket was chirping, it was telling me to stop and just let it go, but no. I decided to be an emotional masochist. 

I read the research again and again and again. All things I had read a year earlier, but because I was pregnant again, in the third trimester with this precious child who has restored our hope, clearly that meant I had to read it from this current perspective and all of its emotions. Following the research articles, I then read a blog post summarizing everything in more simple terms. I read through all the comments on the post. I sobbed reading the words of these aching moms, their hearts I know all too well. Some were from the grandmothers writing their accounts of watching their own daughters say goodbye to their babies and having to lay them to rest, how unfair and angry they were that there had to be coffins made that small and why more isn't done to prevent this? I read testimonies of women who have had multiple stillbirths due to cord accidents. I know I should have stopped but I was frozen and my eyes wouldn't stop scrolling. I sobbed with the mere thought of our experience and reliving that again in my mind. Then the panic of oh my God I just can't do this, I can't do this again. When I was pregnant with Hudson, most of the mommy friends I had were having boys as well. We lost Hudson and while it was hard to see any newborn for a very long time (honestly, I had a hard time with it through June of this year, I've just now come to be able to hold and see them), watching all those baby boys enter the world absolutely broke me. This time around, most of my mommy friends are also having little girls and it is just scary to be back here, in the same kind of position. I am terrified of something happening again. I held my belly and rocked back and forth, pretty much just wailing until I couldn't catch a breath and my head felt like it was going to explode from pressure. 

I find it important to share some of his research because we shouldn't be living in the dark about this. It shouldn't be something we fear to hear about. That increases the stigma. We should know our risks and what can happen, what to ask our doctors, what to look for, because maybe then there can be a change. This isn't meant to drive fear into pregnant women, or those thinking about having a baby. We should know these things. Just like we try to take precautions to cancer and knowing our risks for other health-related issues. This information specifically pertains to cord accident deaths.

Essentially, there are various ways the cord can cause a fetal demise. According to Dr. Collins:

"There are many types of umbilical cord issues.  The more common issues include true knots, velamentous or marginal insertions, hyper or hypo coiling, lack of Wharton’s jelly, 2-vessel cords, and compression." 

What is most common is a nuchal cord accident and that is classified in two types. Research states:

"Type A is a wrap that can possibly be undone with movement or delivery of the baby. Type B is a hitch that is impossible for the baby to release. If a type B loop around the neck, ankle, or other body part is pushed off the body, a true knot is formed.

With umbilical cord issues, the factor that determines the risk is the amount of slack available. For this to be determined, the cord location, cord structure, placenta, placental position, cord length, insertion site, and position of the baby must all be evaluated and considered. Short cords have been associated with an increased risk of neurological insults and long cords have been associated with an increased risk of fetal death."

Yes, it is true. There are babies born all the time who have had a cord wrapped around them or are tightly coiled and they live. It is interesting to share though that there are studies taking place to see the impact of cord babies born living, to see if the compression which would have resulted in a decreased blood flow and oxygen in utero had an effect on brain development as the child grows. Some researchers are looking for a link to ADHD and the autism spectrum, as well as other cognitive developmental disabilities. 

The warning signs of cord restriction or compression are as follows:

• There is a link with maternal low blood pressure in the third trimester. 
• There is a link with fetal hiccups.
• There is a link with a slower fetal heart beat. 
• There is a link with both hypoactivity and hyperactivity in the womb. 

His research suggests that most cord accident deaths take place between the hours of 12 am and 6 am, while a mother sleeps. This is when melatonin is produced in the mother's brain, which can cause stress on the uterus. If there is a compression on the cord, the baby may not be able to continue to handle this stress. In addition, a mother's blood pressure will lower while she sleeps which impacts the flow of blood and oxygen through a cord. If there is already distress on the cord due to tight coiling, a wrap or a knot, that is when a fetus is most at risk. If an expecting woman already shows signs of a lower blood pressure, then her blood pressure decreases more when sleeping, if there is any kind of distress on the cord, it increases the chance of fetal demise.

Hudson was a nuchal cord accident type B. It was wrapped three times around his neck, very tightly and he had a very long cord. Because of this, more than likely, he became wrapped early. As he grew and didn't have more room to move, it became more compressed. I fell asleep on May 25 by 10:00 PM and he was kicking me. I got up the next morning in a hurry and didn't feel him before my appointment. This is why I never want to feel Hadley stop moving, especially when I wake up in the middle of the night. The fact that we are doing these sonograms with Hadley weekly would show by this point if her cord was restricted, wrapped, knotted, or compressed - this is one of the things we look for each week at her appointments.

Finally there's the other important piece of information. That when it comes to subsequent pregnancies, it is found that women who have had a cord accident are more likely to have it happen again. But they have not been able to yet conclude why. 

"Work at the Pregnancy Institute has identified that umbilical cord accidents are not random or rare. Women who have had umbilical cord issues with previous pregnancies, have as much as a ten-fold increased risk of umbilical cord issues in future pregnancies. These women need additional monitoring for these concerns."

I scoured but couldn't find any insight into why someone who has had a previous cord accident more at risk of it happening again? I reached out to a research assistant of Dr. Collins who penned a blog post about it to ask about. Within two hours she got back to me. Her response was this:

"Katie – I, too, wish we knew why there was a greater risk of this happening again. There are several theories and a few people studying it – but we don’t know yet. I am hopeful that additional studies and genomics work will give us some answers. I know the anxiety that accompanies this pregnancy after loss – so I also wish you peace and comfort during this time as you await her arrival!" 

So what has that meant for this pregnancy and the remainder of it?

Cord accidents are just one type of fetal death, there are various other causes of stillbirth both known and unknown. What every post-stillbirth, high-risk pregnancy can expect is additional fetal monitoring, appointments and testing. Speaking from our experience and as I've shared a bit about previously, we had a biophysical profile at 9 weeks, then 20 weeks, and starting at 24 weeks, they became weekly. This means a very in depth sonogram, sometimes involving the 3D/4D technology. They watch as she breaths both through her nose and through her mouth, they look at every organ and measure each bone, we look at brain activity. Fluid is measured, placenta is checked, cord is examined. The high risk ultrasound tech doesn't stop until she gets the numbers she needs to see to ensure that everything is the way it should be. Hadley needs to score an 8 on everything and she has done so with each appointment so far. So, being in our third trimester, our plan is that if her score were to ever drop lower, depending on the severity, we have reached the point of her life's viability that my doctor would perform an emergency c-section right away if it were needed. This gives me ease to know that she can be saved if something were to present itself and if we were to catch it. This is also where my paranoia starts to take over. If I don't feel like I felt her enough, I panic and want to grab for the heart monitor right away. It keeps me from sleeping at night if I move and she doesn't move back, which she usually will start moving whenever I wake up and change sides or get up to go to the restroom. I lay there awake until I feel it, if it takes longer, I start to panic. Then I feel her and am at ease, but I'm now wide awake.

To help combat this, I've started a "movement journal" to document the different jabs, kicks and rolls. As discussed above, both hyperactivity and hypoactivity are cited as signs of distress. So you have to think to yourself then what the heck is normal activity? What exactly is too much or too little when people say all the time how each pregnancy, each baby, is different? Now I have this journal and I'll take it to my weekly appointments to review. We can look at her pattern of behavior together along with her biophysical profile stats.

I've made sure that we've established a baseline of my blood pressure. Nurses usually are on high alert to look for an increase in blood pressure, which can be an early sign of preeclampsia, but they don't all necessarily know that a decrease in blood pressure can be an indication of anything. I had to ask for that. Now we make sure that we are looking at heightened and lowered blood pressure by the week. So far, so good.

At 32 weeks, we have it in the plan to start twice a week appointments if we feel it is needed. One appointment will be a non-stress test, the other will be the biophysical profile sono, every week. Each appointment will end with an assessment by my doctor and chance to touch base together. Each hospital varies on when they will induce. My hospital is preferring that patients be induced after 37 weeks, which she said could be 37 weeks and 1 day if we wanted, or we could go closer to 38 weeks. Basically, she said pick your date in that time frame. We have a date decided on, but will talk to her about it next week to confirm that she can schedule us then.

My days are good, I just have moments within those days that can be really hard to get through and/or move on from sometimes when certain thoughts occur. It's hard for me to have this experience of monitoring Hadley so closely and know that if only we had even just one more sonogram with Hudson, maybe things would have been different? Maybe we could have saved him and he could be here too? Why did one of my babies have to die so that I could have the monitoring needed for any others I am to carry? I want to believe that everything will turn out just fine from here on forward but I know the truth is that we don't know that. Never in a million years did I think we'd lose a baby to stillbirth, but we did. What's to say it won't happen again? These are the tough thoughts, the ones that can be paralyzing and make it difficult to move on from. The ones where you scold yourself and say don't you dare go there, but you can't help it because you've already experienced the unimaginable. 

So, because of that, we have to remain hopeful, grateful and pray hard. Each week is a celebration because we are still pregnant, our baby is still alive and we are another 7 days closer to her arrival. 

You may be sick of reading it by now, but sorry. 
Faith over fear has to triumph. 
And so it shall. 

We are hopeful to meet our crying, breathing, wide eyed baby girl in 7 weeks and 2 days. 

The Two Year Journey

August 17, 2014

The Wish Tree - Yoko Ono Exhibit

Guggenheim in Bilbao, Spain

This morning as I laid in bed before getting up, Facebook reminded me that two years ago today we were in Bilbao, Spain. We were wrapping up our first week in the northern part of the country, the Basque Country, wining our way around the Rioja region, then dining our way around San Sebastian.

We had a 24 hour stop in Bilbao before flying to the second half of our trip in Barcelona and Madrid. While there, we visited the intricately designed Frank Gherry Guggenheim Museum, which happened to have a visiting Yoko Ono exhibit. I'll tell you that woman is a trip, but when we weren't giggling or scratching our head in confusion, we stood peacefully at this Wish Tree. It was standing outside of her exhibit hall on the third floor in the open. The interactive piece encouraged visitors to take a tag and write their wish, then hang them on the olive tree. 

A few nights prior in Elciego, we had made a command decision that I talked about in one of my very first posts. We had been married a year and a half, still newlyweds, and full of things we wanted to see and do. We thought we had this large window of time before we decided to start a family someday, but as we enjoyed a Spanish sunset over the Pyrenees, toasting to our 30th birthdays, the conversation turned to discuss that desire for the "someday" to be now. We were eager, excited and ready to start our family.  

A few days later in Bilbao, we stood in front of this Wish Tree. We found tags and pens, each scribbling down our respective wishes, folding them and placing them on a branch. Before hanging it, I took a picture of my wish. Later that afternoon, as we walked around the outside of the museum, looking at the sculptures, we both confessed our wishes and they were the same. 

My Wishing Tree wish

I think back to that time so fondly. I look through the pictures on the rest of the album and our smiles are a bit bigger, our eyes are a bit brighter. It's like we had this secret and we couldn't wait to share it with everyone, whenever there was something to share. We had such a raw and pure happiness. Sometimes it is hard to see pictures of yourself from the before loss life. In the after loss life, you do learn to smile, laugh and be happy again, but it is just a bit different than before. Looking at these pictures, I can't help but feel emotional. There is a yearning for the pure happiness that didn't know the pain of what that road would look like for us. You never think you are going to be the one who struggles with becoming a parent, whether it's due to infertility, miscarriage, stillbirth, or infant death. You have these hopes and dreams for the happiest future, seamlessly procreating like those around you, not knowing what the road will hold. The fact that it won't go the way you think it will, and in some cases tragically wrong, is the farthest thought from your realm of understanding. 

I remember feeling silly for taking a picture of my wish, but I wanted to document that for us. I had to go through my computer files of the hundreds of pictures I took throughout those two weeks to find it, holding my breath that it would pop up. When it came up on the screen, I couldn't hold back. I stared at it for a while, with tears streaming down my face and then the sobs caught up.

It's been a rocky two year journey to get to this point and we are still holding our breath. 

These two years since have provided us with the highest of highs and the lowest of lows. When we got home from this trip, it took us two more months to conceive Hudson that October. Sitting here today and reflecting on this trip, I am two months from October again, the month Hadley is supposed to join us. I'm angry we don't have him with us, as I will always believe we should. I'm anxious to get through another two months and fearful of the what if that lies between. I'm annoyed that there is, I guess you can call it, symbolism in this equation.

Those wishes are supposed to continue to hang on the olive tree as a permanent piece, even after the traveling exhibit is gone. I wonder if our wishes are still there, with now probably thousands of others, or if they were removed to make room for others. It is still our wish, and our prayer, as we continue on. We have one Baby Schlieve but he is not with us and our hearts ache to have him when we can't. All the while, we prepare our hearts with the joy and love of the little girl we anticipate and can't wait to have in our arms, take her home to become a family. The very thing that we have longed for these two years and counting. 

Chimichurri Steak and Potato Salad

Ladies, sometimes you just want lighter dinner fare, right? This is difficult when there's a man to feed because they want hearty. Or maybe sometimes you want a light meal but WITH a little hearty. This brings together the best of both worlds combining salad greens with some meat and potatoes. Putting it all together offers you a meal full of protein, iron, iodine and folate. You get your entrée salad, he gets enough food to be full. This may look like a lot of moving parts but once you get going, in the right order, you have it ready in no time!

I've made this with regular potatoes and tomatoes (first picture) and again this week changing it up adding avocado and the purple Peruvian potatoes. I used to work with a caterer who used Peruvian potatoes as part of a passed canape recipe and I always thought they were fun. With the Olympics going on, I decided to tap into all things South America with the Brazilian meat and Peruvian potatoes! Max enjoyed himself an Argentinian Malbec while I enjoyed delicious, clean and filtered water - unlike in Rio right now.

Version with Peruvian potatoes and avocado

Special note: This recipe does require the use of a grill and a small food processor to help you plan accordingly.

Grocery List:
Yields 3-4 servings

For Flank Steak
- 1/3 cup red wine vinegar
- 1/4 cup Tamari or Soy Sauce
- 3 tbsp. honey
- 1/3 cup olive oil
- 2 cloves garlic, minced
- 1 lb. flank steak, trimmed of fat

For Chimichurri
- 3 cloves garlic
- 1/4 cup fresh cilantro
- 1 cup fresh parsley
- a hearty sprinkle of red pepper flakes
- 1/4 cup red wine vinegar
- 1/2 cup olive oil

For Salad
- Heirloom Red and/or Green Leaf Lettuce, rinsed, chopped (sometimes I do a mix of the two, top picture is with green leaf, second picture is with red leaf)
- 1 cup fingerling potatoes, chopped (the purple ones are Peruvian if you want a fun change up on your plate)
- Red onion, sliced
- Cucumber, peeled and chopped (I like to de-seed mine too)
- Avocado, cubed
- Cherry tomatoes, halved (optional)

Every time I make this, I plan to mix up the marinade and let the scored steak bathe in it overnight. However, I have yet to accomplish that. The longest I've been able to allow it to marinate before needing to start cooking is 1 hour, this last time I made it, it was 30 minutes. All of that to say - you can marinate it for 24 hours, or 30 minutes, whatever fits your cook time. If it's on the shorter end, no worries, you will still have a flavorful steak.

1. Start by scoring the steak with a paring knife. For those that are not familiar with scoring meat, instead of me describing it to you, I found this video for you! I am a visual learner so I thought others would appreciate this instead.

2. Mix the ingredients for the marinade in a bowl. Put steak and marinade in a ziploc bag and allow it to soak up the flavors for as long as you are able to allow.

3. Within 30 minutes of putting the steak on the grill, go ahead and begin the rest of the cooking process. Start by heating your grill to 400 degrees. Once heated, you will cook it for 7 minutes and then flip to the other side to cook for another 5 minutes. Once the steak is done, cut it against the grain with a serrated knife (best cut for a flank steak). Again for the visual learners, here you go!

4. Next, pre-heat your oven to 350 degrees. While it is heating, cut your potatoes into bite sized chunks. Toss in olive oil and then sprinkle with salt and garlic granules. Bake for 15 minutes or until slightly browned on cut surface and easily pierced by a fork. If you decide you want to do cherry tomatoes, I roast those in the oven with the potatoes to blister them a bit. Potatoes on one side of pan, tomatoes on the other.

5. In a small food processor, add all of the ingredients for the chimichurri and then pulse until smooth. Set aside until time to serve.

For the most even salad ingredient distribution, plate a heap of lettuce first, followed by the potatoes, red onion, cucumber, avocado, tomatoes (if you use them), then strips of steak. As a finishing touch, spoon the chimichurri over all this goodness and enjoy!

Another Year Older

I don't know about you, but I'm feeling 32.

I remember last year, another mother of loss sent me a message on my birthday saying:

"Happy birthday seems like a weird thing to say because I know this is probably not at all the birthday you had in mind, so I will just say... birthday!! Hoping next year brings you peace and healing!!"

I remember thinking gah, she is so right! It took time, but this year did bring peace and healing.

Do you sit and ponder your previous year right before you become another year older? I do. Just like before ringing in the start of a new calendar year, with birthdays I also think of the past years that have lead to the "me" I am at that very moment.

I remember last year thinking that at 31, though it was two months after losing our son and I was hurting deeply, I had the joy of knowing the deepest kind of love. Of having it demonstrated and extended to me by my parents and family members, by my husband, and now by some of my friends who epitomized true friendship. I knew what it was like to create something so much greater than myself, another life, and then have that manifest into the most wonderful thing I've ever done.

Turning 31, I encountered the greatest loss I can imagine, one that didn't make sense and went against the natural order of life. By 31, I had given birth and then laid my child to rest. I had made funeral arrangements for my baby. I knew what it was like to say goodbye far too soon. To get a call from the funeral home 10 days after he was taken from me saying his death certificate arrived and they needed my verbal permission to go ahead with the cremation. That I hadn't checked the boxes correctly and they needed to verify if I wanted to identify my baby via in person or by picture now 10 days later, or if I waived that right. I had that sheer distraught panic of knowing that my precious baby had been on a cold slab for 10 days. TEN DAYS. I had a moment of hysterical break down when I passed that funeral home the next day on my way home from a friend's house (coincidental, I swear) and pulled into the parking lot sobbing my eyes out, knowing my baby was still in there, not with me, he was alone. Don't worry, I wasn't about to go bust down the door or anything, I just needed that moment to be as close as I could be to him one more time. I tell you, an experience like that does something to you, friends. That's something I haven't shared here until now.

Last year I remember being in such a heartbroken state thinking surely by this time next year we will have a baby in our arms. Surely. Oh the life lessons and experiences that 31 would hold.

By 32, I now know more pain than I thought possible, but I also now know redemption firsthand. I lost grace and had it restored. I've gained important friendships through a new walk of life, strengthened existing ones that taught me more than I thought possible, and parted ways with others who couldn't stand with me in darkness. I've learned how to stand with others in their darkness, to not just be there in the good times, but to show up in all times. 

I've learned humility, more about humanity, a truer sense of empathy and compassion.

I've learned a lot about my marriage, about my spouse, and because of that I got off cruise control and learned how to love my husband better in the ways that he needed, as he has taken the active effort to do the same for me.

I've learned to cut out and just remove the bullshit from my life. Pardon my language but that's what it is sometimes, straight up bullshit. I didn't realize how much of it I muddled in my before loss life but can now distinguish it from what is truly important.

I've learned to appreciate my family even more so than I already had. As I was laying in bed over the weekend, I thought about how Hudson will always be my first baby. He made us Mommy and Daddy. Regardless of him being with us or not, that was the most special day to Max and me because we became parents. As we prepare to welcome Hadley, that day will be immensely special to us as well, as will any of our baby's births we are blessed to have in our lives. Individuals are celebrated on their birthdays but what a special day it is for their parents and family members too! This birthday, I wanted my parents to know how it's not my day but it's OUR day. I made them parents. We had a huge family dinner celebrating all the summer birthdays in our family but in my mind it wasn't just the birthdays, it was celebrating a family unit. I've never looked at a birthday like that before.

As I enter this new year, we don't have that baby I thought we'd surely have in our arms by this point, but we are hopeful of her upcoming arrival. For more than a decade my birthdays have been a production. I've spent the better half of my professional career in event planning, so planning parties are my thing. As Facebook reminded me of pictures from birthdays past, all the themes, costumes and fun exclaiming BEST BIRTHDAY EVER, I had a moment of reflection.

This year, 32, was just us. Over the weekend, we had a dinner date just the two of us at my favorite restaurant. The following night, we celebrated as a family, with all of my family. We spent my actual birthday enjoying a day off together at our favorite spa, then doing everything and nothing at the same time. We took a nap and hung shelves in Hadley's room. We cooked our favorite meal together with a jazz playlist going in the background. Max made me a birthday cake. After dinner as I came out from our bedroom to all the lights off in the house, the only light came from the glow of birthday candles. He sang happy birthday, with George panting in the background, baby girl wiggling away in my belly. At that moment, I realized that this was the best birthday.

I know myself better than I ever have before. I have a sense of personal fulfillment, when last year I felt empty and before then I was always looking for something more. This year, I feel more whole than I ever have. So here's to another year older, and to whatever 32 has in store.

Living on a Prayer

When we hit the 18.5 week mark in early June, I remember thinking okay, this is our halfway point. That day I was driving and I swear to you, Bon Jovi spoke to me over the radio waves. I fan-girled so hard to that song, belting out ohhhh, we're half way there, whooaa-oooahh living on a prayer, take my hand, we'll make it I swear whoooaaa-ooohhh living on a prayer. Oh JBJ, if only it were that easy. Sometimes I think I really should have tinted windows and maybe a sound proof vehicle.

Last time, the halfway point was all excitement, just another drop in the bucket. This time, leading up to it was met with fear but then it was a celebration of praise and thanksgiving making it to that point, checking it off the long list of small victories that we hope to surpass. For those enduring Pregnancy After Loss, each week is a big celebration and a relief. We know how you can go from being pregnant one day and then not the next.

When we made it to the 24 week mark, weekly appointments began. Since then, we spend at least an hour and a half on Thursdays at the hospital, first with the high risk ultrasound tech having a biophysical profile of our girl, then meet with my doctor afterwards to discuss. With Hudson we had two sonograms total throughout the 33 week duration of my pregnancy with him. With Hadley, I think we've now had ten so far? In our 24 week appointment, she switched over to the 3D/4D unexpectedly and there she was! We saw every little detail of her face and fingers, her arms are always up by her head. It is so incredible to see how she evolves each week, varying between Max's features and mine. I cling to my sonogram pictures of Hudson because it's what I have of him. I find myself doing the same with hers because it just makes me feel closer to her, allowing me to know her just that much more before she arrives.

From today's 27 week appointment.

Overall the second trimester of my Pregnancy After Loss has been pretty even keel. I have definitely had my moments, because I'm human and have experienced a traumatic loss in this arena, but surprisingly to me they have been few and far between. Each time I feel that twinge of worry, she'll start kicking as if she knows her mama needs that assurance. Then there are times I just feel the need to use my fetal heart monitor and hear her heart beating, which then puts me at ease. Starting the weekly appointments became so helpful, just to have that chance to touch base every seven days with my medical team, and to have the chance to see and hear her. It was a chance to ask questions and raise any concern if it was there. Recently, I was losing a lot of hair - like, postpartum hair loss, clumps of hair - so I told my doctor and she said, "Let's do blood work! If you are losing hair, it could be a thyroid issue or anemia. I'll test you for anything and everything!" And she did. No thyroid issue, and though this little one craves beef like, all the time, I am anemic again so we increased my iron and added more biotin. There's no such thing this time as too careful.

As we end the second trimester and move into the third, though the weekly appointments help more than I can express, the nerves seem to be growing. I keep thinking back to my previous third trimester and how it just ended so abruptly. We keep inching closer to that October date circled on my calendar but that doesn't really mean a thing in my book. Every day we are living on prayers. I say them on my morning drive to work. I pray for Hadley to continue to thrive. I pray for other mamas I know who are on their Pregnancy After Loss journey and those growing babies. I pray for the hearts and minds of Parents of Loss who are trying to conceive again. I pray for Parents of Loss who have their rainbow baby with them but the struggles that can bring such as guilt and sadness for not having had that experience with the child who isn't here. At night, I drift into sleep with an echo of those morning prayers on repeat and this child representing hope squirming around in my belly, so thankful for every movement.

This is my routine - hoping, wishing, praying. 

One aspect to the Pregnancy After Loss that has been difficult on the heart is navigating the question is this your first? Just like the question that was so hard to receive when I was in the trenches of my grief, do you have any kids? I reached a point of mastering that answer, finally getting to a place where I used my better judgement of when to use which practiced response in a given situation. Though it took some time to feel okay with it and separate the acceptance from the guilt of the answer, sometimes a simple no is just easier. Not every person was someone I felt the need to expand on that detail of my life with. If it's anyone I would anticipate knowing beyond an initial first meeting conversation, I can muster a smile and bravely say that we have a son watching over us from Heaven. I've learned to read people and which situations will warrant what kind of reaction. Some people are uncomfortable, some want to know more, others may have had a similar experience or know someone who has and we share a moment.

As soon as I started showing - which happened much earlier and faster this time given I had just been super pregnant less than a year before my uterus started expanding all over again - strangers everywhere were coming forward with that question. With these hormones and a still grieving heart, I found myself at a loss all over again of how to answer something that seems so similar, yet is so different. You don't want to not acknowledge the child you carried through a pregnancy and labored with, but on the other hand, sometimes it is just worth being selective with your answer. Sometimes it is far easier to say yes, this is my first and then hope that is the end of the conversation. However, I learned that is rarely the case.

The times when I choose not to share, it's usually situational but then people have advice. They tell you all about what to expect, what to do for certain pregnancy ailments, share with you about their first pregnancy. They ask the gender and then when I tell them, weigh in on how girls are just the best. I smile and know it is meant with the best intentions. They don't know that in my mind, I had the chance to have a little boy and he isn't here. That to me, having that little boy would have been the absolute best and something I had been so excited for. I still mourn not having this time with Hudson as a "boy mom" and all that I had envisioned with that. Sure I could have that chance again, but not with him. Sometimes I want to interrupt people and tell them I have done this before, to share my own anecdotes of my first pregnancy, or how my body did with labor and delivery too, or compare my post-partum recovery. However, then it feels exhausting to backtrack and not worth the words, so I let them tell me and just nod along silently.

Yesterday I was at a store and had picked up a wall hanging for the nursery. A lady behind me sitting on a bench asked if I was having a girl, and I said yes. She asked if it was my first? In that moment, I decided to respond that this is my second. She asked how old my other little one is and I felt the lump in my throat form as I told her he is in Heaven. She put her hand on my arm and said she had a son in Heaven too. She asked me if this baby had a name yet and I told her. She said she would pray for Hadley often and that is all we could do, that we live on prayers, thanksgiving and grace. She then pointed at a group of women at the front of the line and said those five are her daughters, her blessings after loss. She said she knew I would have mine too. There we were, two mothers, thirty years apart in age, sharing a moment together in line at the Sample House. Tears in both of our eyes, her five adult daughters buying half the store and gabbing in front of us, with my girl kicking my ribs. No more words were exchanged, just squeezes of the hand and smiles from one member of "the club" to another. An opportunity to share a moment with someone else like you, in a world where you feel like a statistic. While I don't believe everything is part of a divine plan, I believe that He puts special people in your life or in a situation at needed times. I look at them as angels. At that moment in time, that lady was an angel to me.

Until Hadley is here safely, we will continue to be living on a prayer, and like that angel lady in the store added, with thanksgiving and grace.