In choosing to have another child, Hunter and I are choosing to accept that we could have a really hard birth story all over again. And we have made peace with that.
In reality, though none of us *want* to have a hard birth story and are hoping for the absolute best, by going through with a pregnancy, we are in one way accepting the reality that anything can happen. Usually unconsciously because we humans do love living in ignorant bliss.
Hunter and I walked into our first pregnancy probably a smidge more aware of risk than someone who doesn't have preeclampsia as a family history. That doesn't mean we truly thought anything would go wrong, though. And the same goes for this pregnancy. There is risk of any number of things happening just like any other pregnancy, and there is the chance that it could all go swimmingly.
But exactly how *much* risk of a second pre-e experience are we walking into? Unfortunately, preeclampsia is not well researched enough to be able to predict who will experience it and when. There are some risk factors that have been measured to narrow down who might be more likely, but it's not an exact science. The fact that I have now experienced it once does raise my risk by a few percentage points, unfortunately. And at the same time, my risk of a second recurrence being as bad as or worse than the first time has lowered significantly as well.
My only known risk factors during Arthur's pregnancy were that it was my first and there was a history in my family of pre-e. That's it. I didn't hit any of the other markers for various conditions or background that can raise one's chances. From an overall health view, I shouldn't have experienced any issues. But here we are today, painfully aware of how unpredictable preeclampsia remains to be.
So how did we make peace with unpredictability if...
1. The first time resulted in serious health emergencies for both myself and Arthur,
2. We experienced a month long NICU stay that was the hardest thing we have ever done, and
3. Our risk of experiencing all of that again has gone up slightly?
When I list it out like that, it becomes abundantly clear why so many people who have experienced difficult births and the NICU struggle terribly with whether or not they would like to go through another pregnancy. Why put yourself through it? Why accept risk? Why would you choose to believe that it could go differently if it could also just as easily end in heartache? That seems plain irresponsible. Selfish, even! Who do we think we are?!
Cue spiraling into indecisive despair.
The choice is personal, it's private and it's none of your business.
She says as she blabs openly about her own mental gymnastics.
The point is, everyone comes to the conclusion that fits their family best. And that's all that actually matters.
But in the spirit of over sharing with absolutely zero regard for anyone else's opinion except my own and that of medical professionals, I will happily jabber on about how we got here.
For me, personally, experiencing pre-e and the NICU was a giant lesson in letting go of control. Like, really letting go. Like, *actually* finding peace in the unknown. For *real*. Which is an absolutely bonkers sounding concept to someone like me.
Finding peace in the unknown is not the norm for someone who has experienced anxiety about the future for her whole life. But it is becoming more natural for me to say "Alright, this is the current situation. I can control my own actions within reason right here and now and that's the only place my energy really matters. Sending it to the future (with worry and what-ifs) just wears out present me."
But I'm not just throwing caution to the wind and saying "Whatever happens, happens" with no consideration of the cold, hard facts. I spent plenty of time evaluating my own risk and the vast differences between life when I was pregnant with Arthur and life now.
Things I have considered:
1. When I was pregnant with Arthur, the world was smack-dab in the middle of the pandemic and I was working arguably one of the most highly affected and severely demanding non-medical jobs possible as a public school teacher. The stress was immense. Stress and preeclampsia risk do not get along and in fact stress has been linked to higher rates of more severe pre-e.
Now, I am a stay at home mom who pours beer on the weekends. We are not in the cushy financial spot we used to be when we had two nearly equal incomes (for the record, I made more than Hunter when I taught full time, thanks SJUSD), but we are happy and healthy and doing exactly what's right for our family at this point in our lives. And that's worth every modification we've made.
2. The change in how much stress I take on daily has changed my sleep. When I was pregnant with Arthur, I had horrid pregnancy insomnia multiple nights a week. Definitely hormone and stress induced. Poor sleep leads to more stress which leads to poor sleep which....you get the idea.
Chronic poor sleep is really hard on the cardiovascular system (hypertension and poor sleep are best friends) and the body's ability to regulate hormones as well. Pregnancy makes a huge demand on the cardiovascular system (you have literally double the blood running through your body) so if the sleep is off, the body is working extremely hard to regulate all the "extra" it needs to deal with. Additionally, one's heavily fluctuating hormones need all the restorative rest possible because with adequate rest comes adequate responses from the adrenal system.
This time around, Arthur is the only sleep wildcard I've had to deal with for the most part (with only a few toss-and-turn insomnia nights thrown in there instead of dozens). And he's a GREAT sleeper the vast majority of the time. Honestly we wouldn't be having another right now if he wasn't, that's how important sleep is to me.
I credit this change in sleep to the greatly reduced stress I take on every day and absolutely believe that good sleep is good medicine.
3. I take low dose aspirin daily and have since week 12 of this pregnancy. My doctor recommended it as a way to help my cardiovascular system keep pathways open and ward off slight hypertension should it develop. The data shows that pregnant people who take low dose aspirin are at slightly lower risk of developing severe preeclampsia.
I also take a hefty amount of magnesium daily. Magnesium comes in *many forms* and only a couple of them are meant to make you poop, so CALM DOWN. If you're a nerd like me, start here to learn about types of magnesium supplements https://www.healthline.com/nutrition/magnesium-types
I take a magnesium supplement blend that supports cardiovascular health as well as stress hormone management. Once again, pregnancy is demanding. Supporting the most highly taxed systems in the body is the name of the game for me.
4. I have surrounded myself with positive post-preeclampsia birth stories. Anyone can doom scroll, but can you seek out the good news? Are we even conditioned to do that anymore? I have made a concerted effort to read not only the statistics but also the personal accounts of families who have experienced pre-e like me and went on to have healthy births later.
It's important to balance the brain like that.
It's important to say "yes, and".
"Yes, I am at slightly higher risk and know what that means. AND I am just as capable as this family over here at having a healthy and pre-e free pregnancy."
I will not live in only one reality, I can hold both truths at the same time.
I can be cautious and hopeful.
I can be prepared for the worst and overflowing with possibility.
I can control my own efforts and understand that, in the grand scheme of things, I relinquish control.
And that's how we got here -- 26 weeks in, healthier than I ever felt while pregnant with Arthur, and completely over the moon that we get to do it again, whatever that may look like.