My First Second Trimester and Everything You Never Knew You Wanted to Know About My Pelvic Floor

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Looking back, I can hardly believe my second trimester has flown by so quickly.  Living through it, however, was like time was standing still.  The night my pregnancy tracker flipped over to show I was in my second trimester, was one of the happiest nights I have had in a long time.  It was just after midnight and I hurriedly flipped through all of the different options that let me compare the size of my baby to various fruits and objects and read all about how our little one was developing.  I think it was that moment that I let my pregnancy start to feel a bit real.  Even with my new-found optimism, I was hooked to my app and religiously checked every morning to see that one more day had successfully ticked by.

Our next big hurdle was our 20 week ultrasound, which is the only ultrasound we would get during the pregnancy here in Manitoba.  It was only a few weeks away, but it felt like an eternity.  I tried to be content with all of the progress we had made so far, but uncertainty and doubt were creeping back in.  I felt once I could see baby and know that everything was okay, I would maybe, just maybe, let myself start to get excited.

 We showed up far too early for our ultrasound appointment, because I was so nervous about being late.  My wife and I chatted light-heartedly in the empty waiting room.  I was so glad she could be with me.  Even with all of the hardships of moving and not finding work as a nurse, I was so grateful to be close to her.

The first portion of the ultrasound was done without my wife in the room, so that the technician could focus.  I laid flat on my back, which was already getting a bit uncomfortable underneath my little baby belly, and got the familiar warm squirt of ultrasound gel on my tummy.  I was so nervous.  She used much more pressure than I would have expected and quickly got to work snapping pictures from various points on my belly.  I felt like I had hit a huge milestone having an abdominal ultrasound, as the rest of my many ultrasounds had been of the invasive vaginal variety.  I was finally living the classic TV/movie ultrasound scene that I had been so fiercely jealous of for the last year.

I hoped maybe the technician would leave the ultrasound screen tilted so that I could see what she was looking at, but of course she didn’t.  I stared intently at the technician’s face (and probably freaked her out a bit) to see if I could catch a glimpse of my baby in the reflection of her eyes.  I tried to read her expression to glean any information I could about how baby was doing.  Is he in there?  How is his heartbeat? Is he okay?  But she was like a statue.  I would just have to wait.  So I stared at the ceiling trying to have patience.

 After 15 minutes she called my wife into the room and I immediately took her hold of my wife’s calm hand.  The technician’s demeanour softened considerably and she swung the ultrasound screen towards us.

 And there he was.  Our little boy.

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 She showed us all of his limbs (there were four!) and his little heartbeat (fast and strong!) and I even saw him swallow a bit of amniotic fluid (go baby go!), preparing for breathing outside of the womb.  He was just perfect.  He was swimming around like crazy and moving his little hands and feet.  I could have watched him forever.  My heart exploded with joy and relief and my eyes welled up with tears.

 I left the hospital walking on a cloud.  And for the first time my wife and I started talking about names and making plans for meeting our little one.

 Maybe we were going to be okay after all.  So powered by hope and the sight of our son, I let my type A personality take over and start planning for the future.

 I had already been reading books, listening to podcasts and generally absorbing any information I could get my hands on regarding birth and pregnancy since well before my miscarriage.  So now I was lucky enough to have the opportunity to put some of what I had learned to good use.  I had my diet and exercise pretty much under control – my diet was 99% plant based since becoming pregnant again and I was walking about 30 hours a week with my job.  I was de-stressing with meditation a few times a week.  Though my sleep pattern was irregular due to work, I was sleeping a lot, and felt rested most of the time.  I took time to connect with baby, rubbing my belly and having little chats with him.  And more importantly, the fatigue and nausea from my first trimester faded into the back ground and was replaced with renewed energy and a solid appetite.  I felt really lucky.

One of the themes that kept coming up in my baby research was the prevalence of pelvic floor issues in the post-partum period.  It’s kind of become become the norm for a woman to lose bladder control while laughing or sneezing after having a baby.  You see this reflected often in our pop culture and various TV shows.  As it turns out, peeing your pants isn’t really normal.

Everyone has been talking about Kegels for a while, but now we are starting to have a more in-depth discussion about the mysterious muscles of the pelvic floor, which is really what we are trying to target with Kegel exercises.

 So what is this pelvic floor thing all about?

 The pelvic floor is a sling of muscles that supports your internal organs and controls the opening and closing of your urethra, vagina and anus.  So it’s kind of a big deal.  And yet there is not a lot of knowledge out there about the impacts of pregnancy and birth on this important muscle group.  After listening to more than a few experts rant about how this is in fact not normal, I decided to do something about it.

 As it turns out, there are physiotherapists who specialize in the pelvic floor!  How cool is that?  And, as it turns out, there were a couple in Winnipeg, so I booked myself an appointment.

 I was called into a small office with an examination table and shook the physiotherapist’s hand.  She had a kind face, excellent posture and a calm demeanour.  She had her trusty pelvis model in her hand and some diagrams of the pelvic floor.  She began her explanation with a tone that sounded like I was the umpteenth patient she had explained the pelvic floor to, but I knew that I probably was the umpteenth person she had explained the pelvic floor to, so I didn’t mind.

 After her teaching, she explained the pelvic floor exam that she would perform.  How is she going to assess my pelvic floor, you ask?  Well, vaginally, of course.

I took my bottoms off and laid on the exam table.  She donned a glove with some lubricant and gently inserted her finger in my vagina.  She was very matter of fact about the whole thing and I appreciated her professionalism (though she did sneeze halfway through the exam, which was about as awkward as you might imagine it to be).  I hadn’t really had a health care professional get that up close and personal with me since my miscarriage, so I was glad that I felt at ease with her.  I reminded myself that this was nothing compared to what giving birth was going to be like, and that encouraged my embarrassment to fade away.

 She had me perform a few exercises to test the strength of my pelvic floor.  First, she had me perform what is commonly known as a Kegel.  Basically, it is fully tensing your pelvic floor (as if you were holding in pee) and fully relaxing your pelvic floor (as if you were trying to not hold in pee).  She rested her hand gently at the top of my baby belly, to assess if I was assisting my pelvic floor with my abdominal muscles.  This would be a sign of weakness or poor control of the pelvic floor, and it is really important to target the pelvic floor muscles specifically.  After that, she had me contract my pelvic floor for a full minute!  I managed to last the full 60 seconds and felt pretty pleased with myself.  The last exercise she had me do was to contract and relax my pelvic floor in quick succession.  The hardest part was being aware of fully relaxing between each contraction, which is an oft neglected part of the Kegel.  In fact, one of the keys to a smooth birth is being able to fully relax your pelvic floor to allow baby to pass through!

 At the end of the exam she said my pelvic floor was excellent and she couldn’t feel or see any problems with strength or coordination.  To be honest, I haven’t done anything out of the ordinary (not even Kegels on a regular basis) to maintain my pelvic floor strength, so I was pleasantly surprised to hear that everything was good.  I actually didn’t even know if I was doing a Kegel properly until she assessed me!  I found the description of elevators moving up and down that you often find in Cosmo-like articles really confusing.  Turns out, it’s really not that hard to do!  I have not had a lot of pelvic floor pain or bladder leakage during my pregnancy, but I wanted to make sure I was going into birth with my body in top notch condition.  The physiotherapist said that she wished more pregnant people would come in prior to birth, as a lot of terrible problems (like pelvic organ prolapse) could be prevented or at least improved if issues were addressed as soon as possible.

 At the end, I asked her if everyone should just be doing more Kegels and she said that the solution was not as simple as that.  Sometimes people can have a pelvic floor that is hypertonic, or too tight, which can cause just as many problems as someone who has a pelvic floor that is hypotonic, or too loose.  She said the best first step is to have an assessment done to find out what’s going on down there!  I’m a firm believer that prevention is so important!  One of the ladies I met in my hypnobirthing class said that she had a lot of pelvic floor issues related to snowboarding, and I’ve heard stories of dancers and yogis who have issues as well.  My physiotherapist recommended some exercises specifically for me, including Kegels, basic core movements on an exercise ball and some hands-and-knees core exercises.

As they say, an ounce of prevention is worth a pound of cure, so get those pelvic floors checked, ladies!

-K

Pregnant Again – A Bittersweet Joy

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Guys, we did it!  I’m pregnant!!!

I apologize for the radio silence over the last couple of months, but we’ve been dealing with A LOT.  I’ve missed you all.  Let’s start at the beginning shall we?

After my last negative pregnancy result, a lot was riding on our third attempt at IUI.  Not only that, but I had moved to Winnipeg (#militarylife) to be with my wife while she learns to fly helicopters (#mywifeisbetterthanyours).  So now I was 778 km away from my fertility clinic.  Yikes.

I got my period like clockwork shortly after my negative result.  I informed the fertility clinic and hoped they could get me an ultrasound in Winnipeg to save me a long drive back to Saskatchewan.  Unfortunately, the fertility clinic in Winnipeg was absolutely no help (not to mention they have a nine month wait list!).  The closest ultrasound they could get me was in Yorkton, SK.

On day 13 of my cycle, I got into my car and drove 5 hours to the bustling metropolis of Yorkton and had my 10 minute ultrasound.  Now, I had a decision to make: head back to Winnipeg, with a chance I may have to be in Saskatoon the next day for the IUI procedure, OR continue on to Saskatoon and hope that my body’s cycle would be as consistent as it was last cycle.  So armed with hours of podcasts, off to Saskatoon I went.

About an hour outside of Saskatoon, the clinic called me with the results of my ultrasound.  I barely breathed as I listened to the results.  The good news was that I had two eggs developing!  Woo hoo!  I had somehow transformed into a fertility goddess!  Practically a medical marvel!  The bad news was that the eggs weren’t quite ready to go, and my IUI was scheduled for three days from then.  Sigh.  After almost 8 hours on the road, I did a big ol’ U-turn and headed back from whence I came.

Aside from driving for 16 hours, the IUI went off without a hitch later that week.  I meditated for 10 minutes right after and relaxed, with my feet in the air, for about an hour in my hotel before heading back home to Winnipeg.

I just kept thinking, “third times a charm”.  C’mon body, you got this.  And, if I had two eggs ready to go, how could this not be my chance?

The two week wait, seemed better than the other ones.  It could have been the acupuncture, meditation or maybe just that I was used to the anxiety and knew that increasing stress levels never really helped much.  My wife’s tendency to not worry so much about things you have no control over seems to be wearing off on me.  I was also very unemployed after our recent move, so I was able to rest as much as I wanted and take time for myself.

A couple days before I was due for my pregnancy blood work, I felt the familiar itch to take a pregnancy test.  I had done a pretty good job keeping my anxiety at bay.  I had an extra test from my previous attempts, so I grabbed a cup and headed to the bathroom.  I did the dip and then laid the test on the counter to wait.  I swear time stands completely still as soon as that stick comes in contact with urine.  When I didn’t see that second little line appear instantly I just walked away.

Screw this.  It’s negative again, isn’t it?  Just like last time.  Whatever.  It’s fine.  We’ll try again.  We can still adopt.  I’m infertile. Broken.  I shouldn’t have even checked.

My mind was a whirlwind of negativity and fear.  I had watched so many negative pregnancy tests, turning them to see the result window at different angles, in a different light.  My desire was so strong I felt I would will that little line to appear, but it never did.

I went to the kitchen to do something that I don’t remember.  A couple minutes later, I walked back into the bathroom.  As quickly as I had dismissed the initial results, I felt the urge to know for sure.  The familiar feeling of hopefulness and potential that comes from being at the top of that fertility roller coaster overcame me.

And there was that second line.

It was clear as day.  Vibrantly blue against the white background of the test window.

I was pregnant again.

I’d like to say I was overjoyed.  I’d like to say that I was thrilled and excited and elated.

I mean, I was all of those things, but I also wasn’t at the same time.  I was also scared.  I was nervous and anxious and unsure.  I had been here before.  And it all disappeared in the blink of an eye.  A positive pregnancy test to most people means a baby in nine months.  To me, it meant the beginning of a fragile journey where a happy ending was not always the outcome.

A few days later blood work confirmed I was pregnant and that my hCG levels were rising properly.  I breathed the tiniest breath of relief.  As soon as I confirmed the blood work I set out on my mission to get a midwife.  Even though it felt too early, it’s been my dream to have midwifery care and by-gosh I was going to get it.

I actually was accepted into a midwife’s care in record time!  I called with my information and a day later a midwife was assigned to me.  I had to have some pregnancy karma stored up somewhere in the universe, right?

I was really excited to have a midwife and it made the pregnancy feel a little more real to me.  We had our first appointment at the birth centre in Winnipeg (which is goooorgeous).  Our midwife was warm and friendly and everything I hoped she would be.  We had a nice hour long consultation about health history and our journey thus far.  My wife was a champion and drove direct from her flight training in her flight suit (hot!) to be there for the appointment.  We found out I was due on June 8, 2018.  It felt so far away and so close at the same time.  The next step for me was to get an early ultrasound and hear that precious heartbeat.

Unfortunately, the health care system in Manitoba does not offer early ultrasounds unless there are extenuating circumstances or a need to date a pregnancy.  You’d think that a previous miscarriage would qualify as a reason for an early ultrasound, but nope.  I didn’t qualify.  My midwife offered to fudge things a bit and put me in for an ultrasound for “dating purposes” (even though I practically knew the exact moment of conception), but I might have to wait until I was around 10-12 weeks to get the ultrasound.

I wasn’t willing to wait that long.  I just couldn’t.  This pregnancy already felt so tenuous and delicate that I knew I would lose my mind waiting until almost the end of the first trimester to confirm.  So, back to Saskatoon I went for a 7 week ultrasound at my fertility clinic.

I laid down on the table and the doctor asked me how I was doing.  I said I was morning sick most of the time and very, very nervous.  Her face was kind with the understanding of my history.  In went the ultrasound wand and almost immediately my little baby popped into view on the screen.  My eyes welled up with tears as I heard the doctor measure her heart beat.  A smile spread across my face as the tracing of the 167 beats per minute flowed across the bottom of the monitor.  Baby was measuring perfectly and her heartbeat was strong and fast.

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My relief was incredible, though not complete.  This was a huge milestone for us, but we still had a long road ahead.

As soon as I was dressed, I told my wife, family and close circle of friends who have supported me throughout my loss.  I felt so grateful, not only for the support of the amazing people around me, but also for the hope of starting our family.

The first trimester was a strange time for me.  It was a happy time, of course, but it was also tempered with worry and uncertainty.  Pregnancy after loss is a constant conflict of emotions.  I feel trapped between two worlds.  One world where I look forward to having a big belly and planning pre-natal classes and buying baby things.  Meanwhile the other world taunts me with loss and embarrassment and despair.  I want to be happy and hopeful and look to the future, but it’s challenging with the reality of the true miracle of life.  The reality that nothing is guaranteed.  The reality that life is so, so precious and it could be taken away in an instant.

I’m sure you were all hoping for a slightly happier blog, but apparently that’s just not how I roll.  I guess I’m not naive anymore.  Miscarriage steals the magic and the potential of pregnancy.  Every day does get easier.  As I type this, I am 15 weeks and 5 days pregnant, baby is the size of an avocado and I’m already showing off a little baby belly.

Every morning when I get out of bed I look at my belly in the mirror to see if it’s still there, how big it is, how round it is.  I ask my wife constantly if my boobs are still big, to make sure my body still knows that I have a baby on the way (also because they are ridiculously huge now, so it’s kind of funny).  I check baby’s heartbeat every week with a fetal doppler, just to make sure she’s still in there and doing okay.  Until the last little while, I have tried not to refer to myself as pregnant or talk about it too much, in case it all changes.  I add qualifiers to statements about my pregnancy like “as long as everything works out okay” or “we know anything could still happen”, just to save face in advance.  Just last week my wife sang to our baby and I felt like it was barely real.

I’m so happy to be pregnant.  I know how incredibly lucky I am.  I know so many moms and families would give anything to be in my position because I was once in their shoes.  I was the barren mom looking at pregnancy announcements on Facebook and feeling the sharp pang of jealousy.  We are joyful and hopeful.  My joy just has a bittersweet companion, and I’m not sure when that will change.  Maybe it won’t.

For now, I’m trying to be healthy and meditate and enjoy the holiday season.  It’s going to be a bit hard seeing all of our families again because it was when we saw everyone last that we announced our first pregnancy.  I’m trying to step into my pregnancy confidently and connect with my baby.  I booked a Hypnobirthing class today.  I bought some maternity clothes.  I’m still nervous about our upcoming 20 week ultrasound in January, but I’m not letting that worry take over my life.  We are in a good place.

Thank you in advance for the well wishes.  So many of you amazing people are rooting for us and I can’t thank you enough for your kind words and positive messages over the last few months.  I promise more to follow shortly on the trials of the first trimester and our continued fertility journey.

Have a wonderful holiday season.

-K