Breaking the Silent Barriers (BSB) - Infertility Struggle
A few days ago, this picture turned up on my Facebook timeline and got me totally emotional. Such a happy picture, filled with warmth, swelling with motherly pride – a stark contrast to how I managed to get here. Breaking the silent barriers of my struggle with infertility today.
When after a couple of years of trying, I couldn’t conceive, I knew there was a problem. In my mid-twenties, with no real hurry on donning the motherhood title, I chose to turn a blind eye until one day a few years later, all alone in the little red dot, I had to rush to emergency. A quick assessment indicated PCOS that had also made me gain 10 kg over a period of 6 months. Here, began my medical journey of struggle towards motherhood. In the 8 plus years of my struggle with bearing a child, the ever-invasive questions became a part of life. People didn’t really think before probing or offering advice. I experienced every bit in those questions that came over a period of 8 years. There was concern and care, criticism, taunts and jeering and so much more. All it did was to make me into a social recluse for a period of time. I consciously started avoiding family events where I was likely to be the butt of all attention, sympathy and a platter full of unnecessary advice. To see friends and younger cousins bear children was unbearable. The feelings were mixed. On one end, I felt thrilled for them and on the other, a feeling of despair for myself. There was anguish within, a sense of betrayal by my own body. I felt dejected that my body couldn’t perform that one basic function. I felt alienated. I couldn’t speak about what I was going through without garnering sympathy. It felt absurd that people were nosey enough to want to know why I didn’t have any children. Was it by choice? Was I on contraceptive pills? And some even went on to ask if everything was fine between us In a country and culture where everyone is presumptuous and instantly makes it one’s business to probe into someone’s personal life, it is not easy to survive the insensitivity unless one is hardened to this. I had reached a point where I knew I had taken enough nonsense. Being asked the same questions again and again, even though well-meaning, was quite hurtful. People even assume they have to have something to say, be it “Oh, its not yet time for you, or you need to lose some weight, you are too young to be stressing over this or simply enjoy this phase, once the kids come, life is going to be difficult. I had reached a point where I had convinced myself that if I was meant to be childless, then be it. I wasn’t going to fight it, but there was a stronger need to have a child and I refused to quit until I had tried all. The first set of tests turned up with nothing and I was told I was too young (at 28) to be worried about not bearing a child and that it will happen. A few more years went by and finally in my early 30’s I could feel the pressure of the biological clock ticking. We decided it was time for assisted therapy and the gynaecologist agreed this was a confirmed case of undefined sterility with no known reason. After over a year of various things when nothing worked, IVF was the only next option. The long waits, the procedures, the hormones, the mood swings, the ultrasound scans, the medications, the injections, the entire repertoire is too painful to elaborate on. We managed to have 5 viable embryos (thanks to ICSI-Intracytoplasmic Sperm Injection). I remember being asked how many I wanted to implant and without batting an eye, I asked for three.
The gynaecologist reminded me that I might end up having triplets and it could get complicated but who was thinking. The more the merrier. I had waited too long. There was an agitated anticipation of what was to be, following the implantation when I spent the longest 2 weeks, worrying and fretting over the slightest cramps, walking as gingerly as I could, scared about losing the implantations, spending most of my time propped in bed with my feet up on a pillow. On the day I was to get the results, I listened with bated breath when the nurse called me to let me know the beta hcG titre was high enough for a positive pregnancy but I was to report back to the hospital each day to get progesterone shots. My joy knew no bounds. An ultrasound a few weeks later showed me what I was so eager to know- not one but a twin pregnancy with two hearts beating within. It is difficult to put into words what I went through in that moment but there was a steady flow of tearful gratitude and a sense of disbelief.
I lived in euphoria, with dreams of investing in a double stroller, anxious thoughts about how life would be, managing twin babies and thinking about the gender.
The euphoria only lasted for a couple of weeks. A second ultrasound scan, few weeks later, shattered my dream. At the subsequent visit, I asked my gynaecologist the nagging question if the twins were sharing the fetal sac which would make the pregnancy more complicated, or if they were in their own separate sac. He refused to answer and continued probing with the scanner with a sombre expression. After what seemed like eternity, he said, “I have good news and bad news for you. Which one would you like to hear first?”. The good of course I said. “The twins are not sharing the foetal sac.” I smiled with relief, but then what is the bad news here doc? “Unfortunately, you have lost one. There’s only one foetus and an empty foetal sac.” I don’t have any words to even express the state of shock I felt. Only one??? But I saw them both…I heard both their heart beats?? How could this be?? What do you mean an empty sac? How can a baby just disappear?? I don’t understand….
How does one cope with the loss of a baby, yet to be. A baby that was an intimate part of the dreams I was weaving in the past few weeks. The entire thing was too incomprehensible to my grieving heart. How could the baby just disappear? I had just begun to live in hope. Life couldn’t get so cruel. I learnt a new medical terminology that day – Vanishing Twin Syndrome. A condition where, one of the foetuses, gets absorbed by the other existing twin foetus, or the mother, with or without visible symptoms. There was simply an empty sac, a sad reminder of what was to be. I was informed that this placed my pregnancy in a critical state, and I had to be extremely careful about the first trimester and continue with the painful, daily progesterone jabs to keep the pregnancy going. I went from a state of “will I ever get pregnant” to “will this pregnancy last”. For weeks, I mourned the loss of my unseen baby, not understanding the why’s and what’s of life and its mysterious ways. I convinced myself that everything happens for a reason and continued to live each day with hope. The first trimester passed by uneventfully with no pregnancy symptoms I could relate with apart from the whopping 8 kg I had already gained thanks to the progesterone jabs. At week 12, I went in for the Nuchal Translucency Scan and Down’s Syndrome test. Having read through every minute detail of the procedure and seen scores of YouTube videos, I knew everything was normal. My age, 33 then placed me at a higher risk for a Downs Syndrome. I was given a calculated risk of 1:800 and recommended for the Amniocentesis test, a prenatal test that requires a fine needle aspiration of the amniotic fluid but not without the risk to the mother or the baby, albeit very low. The “risk” was enough to keep me off any further tests. The attending nurse from my gynaecologist’s office kept calling me incessantly to fix up an appointment for the same. I was trying to push the date until I met with the doctor to understand the need, but she persisted and at one point, I knew I had to decide and I did. “This is my baby. I don’t care about the amniocentesis. Whatever the outcome of the test, I am not giving up on this baby, so I don’t see why I need to put myself at any risk” and she argued, “Madam your risk is high because of your age”. I knew I had to get down to basics and I told her, she was looking at the wrong numbers. I still had a 799 chance out of 800 to have a normal baby and that weighed higher. She was worried the doctor would be mad at her. I convinced her, I would take the entire responsibility of my child’s fate and would speak to my doctor at my next visit and I did. I was enraged. “You knew how stressed I have been with this pregnancy and yet you insisted on me going through this, especially when the scan has been normal.” I agree, I should not have put you though this, was all he had to say to me. Into my second trimester and feeling a little safer about the pregnancy, I was at the hospital again, this time at around week 20, when I underwent the full morphological scan. The report was far from normal. At every step the pregnancy felt like a “touch and go”. The scan told them it was a male baby but it couldn’t clearly show the spine, lips and kidneys.
I was referred to a high-risk doctor, a perinatologist in one week’s time. With no clue about what was to be, I was stuck in a limbo, a directionless state of hell and all alone as my other half was busy studying in another part of the world. For some reason the one week’s wait ended up being longer as my appointment got rescheduled. I had taken a day off from work and walked into the hospital, wondering how my baby’s fate was going to be sealed. I saw other pregnant women there, stressed, probably sailing in similar boats. I was about 25 weeks pregnant at this point. Just as my number flashed, a nurse walked out to the waiting area and called out my name. As I took a few steps towards the room, I felt the first ever movement from within, the very first indication that I had a living human, my little one. It felt like he was speaking to me, reassuring me, he was fine. In that moment, all my stress of the past weeks gave away. The unshed tears just couldn’t be held within anymore. I walked into the room, with tears of joy and relief. The doctor, presuming I was worked up, tried to offer words of comfort suggesting that it could all be fine and there may not be a reason to worry. I remember telling him, “I know everything is fine Doctor”. I must have had him really confused. Anyway, as things would have had it, the scan suggested everything was intact and the previous image perhaps was not as clear owing to my anterior placenta placement. Relieved for the first time in as many weeks, the next few weeks went by and I was back at the hospital for my routine check at week 32. This pregnancy was turning out to be a roller coaster. The baby was not growing. He was smaller than the average at week 32. I was again advised ample rest and a good healthy diet. I was gaining weight steadily even while the baby remained small. Back at the clinic in two weeks, it was week 34. “Oh, you have been eating and resting well, I believe. The baby is growing exponentially fast. Cut down on your carbs, or a natural birth might get complicated if the baby gets too big”. This was turning out to be insane. The baby was over 3.5 kg at this stage. By week 36, a date was fixed for me to get admitted. It was the 27th of September 2009 when I was induced into labour at 8 am. After 12hours of waiting with no contractions and water breaking, I was re-induced at 8 pm. With no effects whatsoever, by 10 am on the following day, it was to be an emergency C section. To add to my woes, my asthma was triggered. Wheezing and coughing, as I lay in the OT under the glaring lights, I could feel my upper body getting cold. Someone spoke to me about the baby being positioned higher and that they would need to give me a hard push on the chest downwards. I could only nod. One…two…three…four….whoosh! I thought I wasn’t going to make it alive but I did. The entire experience was akin to hell and back. No wonder then when it is said that with the baby, a woman is born again. I looked desperately to catch one sight of this little human, who had stuck on tenaciously inside me, winning battles through this journey, finally out in this world to allow me the privilege of motherhood. I don’t really have the words to describe my emotions when I first saw my little bundle of joy. The tears came uninhibited as I told myself, I was finally a “mother”.
Infertility can be a hopeless situation for women wishing to have a baby. But the support and camaraderie of people who are going through a similar struggle can offer valuable perspective. It’s not asking for too much, to be a little sensitive then right. Sonali Medakkar “Our lives are ours to live. No one can live it or write our story better than us”
When after a couple of years of trying, I couldn’t conceive, I knew there was a problem. In my mid-twenties, with no real hurry on donning the motherhood title, I chose to turn a blind eye until one day a few years later, all alone in the little red dot, I had to rush to emergency. A quick assessment indicated PCOS that had also made me gain 10 kg over a period of 6 months. Here, began my medical journey of struggle towards motherhood. In the 8 plus years of my struggle with bearing a child, the ever-invasive questions became a part of life. People didn’t really think before probing or offering advice. I experienced every bit in those questions that came over a period of 8 years. There was concern and care, criticism, taunts and jeering and so much more. All it did was to make me into a social recluse for a period of time. I consciously started avoiding family events where I was likely to be the butt of all attention, sympathy and a platter full of unnecessary advice. To see friends and younger cousins bear children was unbearable. The feelings were mixed. On one end, I felt thrilled for them and on the other, a feeling of despair for myself. There was anguish within, a sense of betrayal by my own body. I felt dejected that my body couldn’t perform that one basic function. I felt alienated. I couldn’t speak about what I was going through without garnering sympathy. It felt absurd that people were nosey enough to want to know why I didn’t have any children. Was it by choice? Was I on contraceptive pills? And some even went on to ask if everything was fine between us In a country and culture where everyone is presumptuous and instantly makes it one’s business to probe into someone’s personal life, it is not easy to survive the insensitivity unless one is hardened to this. I had reached a point where I knew I had taken enough nonsense. Being asked the same questions again and again, even though well-meaning, was quite hurtful. People even assume they have to have something to say, be it “Oh, its not yet time for you, or you need to lose some weight, you are too young to be stressing over this or simply enjoy this phase, once the kids come, life is going to be difficult. I had reached a point where I had convinced myself that if I was meant to be childless, then be it. I wasn’t going to fight it, but there was a stronger need to have a child and I refused to quit until I had tried all. The first set of tests turned up with nothing and I was told I was too young (at 28) to be worried about not bearing a child and that it will happen. A few more years went by and finally in my early 30’s I could feel the pressure of the biological clock ticking. We decided it was time for assisted therapy and the gynaecologist agreed this was a confirmed case of undefined sterility with no known reason. After over a year of various things when nothing worked, IVF was the only next option. The long waits, the procedures, the hormones, the mood swings, the ultrasound scans, the medications, the injections, the entire repertoire is too painful to elaborate on. We managed to have 5 viable embryos (thanks to ICSI-Intracytoplasmic Sperm Injection). I remember being asked how many I wanted to implant and without batting an eye, I asked for three.
The gynaecologist reminded me that I might end up having triplets and it could get complicated but who was thinking. The more the merrier. I had waited too long. There was an agitated anticipation of what was to be, following the implantation when I spent the longest 2 weeks, worrying and fretting over the slightest cramps, walking as gingerly as I could, scared about losing the implantations, spending most of my time propped in bed with my feet up on a pillow. On the day I was to get the results, I listened with bated breath when the nurse called me to let me know the beta hcG titre was high enough for a positive pregnancy but I was to report back to the hospital each day to get progesterone shots. My joy knew no bounds. An ultrasound a few weeks later showed me what I was so eager to know- not one but a twin pregnancy with two hearts beating within. It is difficult to put into words what I went through in that moment but there was a steady flow of tearful gratitude and a sense of disbelief.
I lived in euphoria, with dreams of investing in a double stroller, anxious thoughts about how life would be, managing twin babies and thinking about the gender.
The euphoria only lasted for a couple of weeks. A second ultrasound scan, few weeks later, shattered my dream. At the subsequent visit, I asked my gynaecologist the nagging question if the twins were sharing the fetal sac which would make the pregnancy more complicated, or if they were in their own separate sac. He refused to answer and continued probing with the scanner with a sombre expression. After what seemed like eternity, he said, “I have good news and bad news for you. Which one would you like to hear first?”. The good of course I said. “The twins are not sharing the foetal sac.” I smiled with relief, but then what is the bad news here doc? “Unfortunately, you have lost one. There’s only one foetus and an empty foetal sac.” I don’t have any words to even express the state of shock I felt. Only one??? But I saw them both…I heard both their heart beats?? How could this be?? What do you mean an empty sac? How can a baby just disappear?? I don’t understand….
How does one cope with the loss of a baby, yet to be. A baby that was an intimate part of the dreams I was weaving in the past few weeks. The entire thing was too incomprehensible to my grieving heart. How could the baby just disappear? I had just begun to live in hope. Life couldn’t get so cruel. I learnt a new medical terminology that day – Vanishing Twin Syndrome. A condition where, one of the foetuses, gets absorbed by the other existing twin foetus, or the mother, with or without visible symptoms. There was simply an empty sac, a sad reminder of what was to be. I was informed that this placed my pregnancy in a critical state, and I had to be extremely careful about the first trimester and continue with the painful, daily progesterone jabs to keep the pregnancy going. I went from a state of “will I ever get pregnant” to “will this pregnancy last”. For weeks, I mourned the loss of my unseen baby, not understanding the why’s and what’s of life and its mysterious ways. I convinced myself that everything happens for a reason and continued to live each day with hope. The first trimester passed by uneventfully with no pregnancy symptoms I could relate with apart from the whopping 8 kg I had already gained thanks to the progesterone jabs. At week 12, I went in for the Nuchal Translucency Scan and Down’s Syndrome test. Having read through every minute detail of the procedure and seen scores of YouTube videos, I knew everything was normal. My age, 33 then placed me at a higher risk for a Downs Syndrome. I was given a calculated risk of 1:800 and recommended for the Amniocentesis test, a prenatal test that requires a fine needle aspiration of the amniotic fluid but not without the risk to the mother or the baby, albeit very low. The “risk” was enough to keep me off any further tests. The attending nurse from my gynaecologist’s office kept calling me incessantly to fix up an appointment for the same. I was trying to push the date until I met with the doctor to understand the need, but she persisted and at one point, I knew I had to decide and I did. “This is my baby. I don’t care about the amniocentesis. Whatever the outcome of the test, I am not giving up on this baby, so I don’t see why I need to put myself at any risk” and she argued, “Madam your risk is high because of your age”. I knew I had to get down to basics and I told her, she was looking at the wrong numbers. I still had a 799 chance out of 800 to have a normal baby and that weighed higher. She was worried the doctor would be mad at her. I convinced her, I would take the entire responsibility of my child’s fate and would speak to my doctor at my next visit and I did. I was enraged. “You knew how stressed I have been with this pregnancy and yet you insisted on me going through this, especially when the scan has been normal.” I agree, I should not have put you though this, was all he had to say to me. Into my second trimester and feeling a little safer about the pregnancy, I was at the hospital again, this time at around week 20, when I underwent the full morphological scan. The report was far from normal. At every step the pregnancy felt like a “touch and go”. The scan told them it was a male baby but it couldn’t clearly show the spine, lips and kidneys.
I was referred to a high-risk doctor, a perinatologist in one week’s time. With no clue about what was to be, I was stuck in a limbo, a directionless state of hell and all alone as my other half was busy studying in another part of the world. For some reason the one week’s wait ended up being longer as my appointment got rescheduled. I had taken a day off from work and walked into the hospital, wondering how my baby’s fate was going to be sealed. I saw other pregnant women there, stressed, probably sailing in similar boats. I was about 25 weeks pregnant at this point. Just as my number flashed, a nurse walked out to the waiting area and called out my name. As I took a few steps towards the room, I felt the first ever movement from within, the very first indication that I had a living human, my little one. It felt like he was speaking to me, reassuring me, he was fine. In that moment, all my stress of the past weeks gave away. The unshed tears just couldn’t be held within anymore. I walked into the room, with tears of joy and relief. The doctor, presuming I was worked up, tried to offer words of comfort suggesting that it could all be fine and there may not be a reason to worry. I remember telling him, “I know everything is fine Doctor”. I must have had him really confused. Anyway, as things would have had it, the scan suggested everything was intact and the previous image perhaps was not as clear owing to my anterior placenta placement. Relieved for the first time in as many weeks, the next few weeks went by and I was back at the hospital for my routine check at week 32. This pregnancy was turning out to be a roller coaster. The baby was not growing. He was smaller than the average at week 32. I was again advised ample rest and a good healthy diet. I was gaining weight steadily even while the baby remained small. Back at the clinic in two weeks, it was week 34. “Oh, you have been eating and resting well, I believe. The baby is growing exponentially fast. Cut down on your carbs, or a natural birth might get complicated if the baby gets too big”. This was turning out to be insane. The baby was over 3.5 kg at this stage. By week 36, a date was fixed for me to get admitted. It was the 27th of September 2009 when I was induced into labour at 8 am. After 12hours of waiting with no contractions and water breaking, I was re-induced at 8 pm. With no effects whatsoever, by 10 am on the following day, it was to be an emergency C section. To add to my woes, my asthma was triggered. Wheezing and coughing, as I lay in the OT under the glaring lights, I could feel my upper body getting cold. Someone spoke to me about the baby being positioned higher and that they would need to give me a hard push on the chest downwards. I could only nod. One…two…three…four….whoosh! I thought I wasn’t going to make it alive but I did. The entire experience was akin to hell and back. No wonder then when it is said that with the baby, a woman is born again. I looked desperately to catch one sight of this little human, who had stuck on tenaciously inside me, winning battles through this journey, finally out in this world to allow me the privilege of motherhood. I don’t really have the words to describe my emotions when I first saw my little bundle of joy. The tears came uninhibited as I told myself, I was finally a “mother”.
Infertility can be a hopeless situation for women wishing to have a baby. But the support and camaraderie of people who are going through a similar struggle can offer valuable perspective. It’s not asking for too much, to be a little sensitive then right. Sonali Medakkar “Our lives are ours to live. No one can live it or write our story better than us”
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