Have you ever been part of a raffle drawing and they’ve read off every number but the last and so far all the digits match the ones on your ticket? You’re starting to get excited but you also know that there are nine other digits besides yours that they could call, so you temper your excitement and hold your breath instead?
This is exactly what it feels like when you get pregnant after experiencing infertility and/or loss.
As you navigate your way through those first tentative twelve weeks, you are super hopeful and want to get excited, but also want to guard your heart in case anything goes wrong. So, you spend the entire first trimester of pregnancy in this state of cautiously optimistic anticipation and nerves with hopeful hearts and bated breath.
Warning this article could be triggering to those who have experienced infertility and/or pregnancy loss.
I am sure that all pregnancies come with a bit of anxiety and nerves. There’s a new little life inside of you and it’s exciting and scary all at the same time. But there’s something about a pregnancy after infertility and/or loss that magnifies this anxiety, so much so that there’s a field of doulas and counselors who specialize in supporting this niche of women through this confusion of emotions. You want to be excited and joyful, but you also know what could go wrong, and it’s terrifying.
I know all too well the delicateness of early pregnancy.
There was a time when that was not the case. Before many years of unsuccessful attempts to conceive, infertility diagnosis, and fertility treatment, I was naïve to the frailty of pregnancy. Even when we embarked on our first round of in vitro fertilization, I was naïve to it. I remember after our transfer, my husband and I were so excited! We talked nonstop to the embryos that we had transferred — nonstop and out loud (gasp!): “Hi babies! We hope you stick around. You’re going to love it here. We have three fluffy cats. We’re going to the beach next week. Hey babies, that’s the ocean!”
I was the neurotic person who took pregnancy tests every morning after that. But I soon noticed a pattern in my pregnancy tests that I didn’t like: the line was getting lighter not darker. I consulted with other ladies who assured me that, “A line is a line. Don’t stress about it.” But later that week, my fears were confirmed when the results from my repeat beta blood tests showed dropping HCG levels. We lost those two babies. It was devastating. How foolish to think that pregnancy was that easy! How foolish we were to actually talk to them like they were going to stick around!
You see, the struggle of pregnancy after infertility and/or loss is that you are not naïve. I often wonder if it was better back when pregnancy wasn’t detectable until you started showing outward signs. Of course, there are many advantages from these scientific advancements, but also our eyes have been opened to the high stakes of those early weeks.
And it’s not just my own experiences that tapers my excitement. Increasing awareness on social media around infertility and loss has led to valuable connections and shared knowledge. I am very grateful to the online connections that I made during our fertility journey that got us to where we are today. But I have also seen or heard just about any way a pregnancy journey can go wrong. From non-doubling betas, chemical pregnancies, and ectopic pregnancies to blighted ovums, not finding heartbeats and more. With all this information, the “a line is a line” theory does not hold water.
So, what does early pregnancy with all this running through your head look like?
I am speaking from my experience of pregnancy after fertility treatment (frozen embryo transfers), but I assume it would look similar for someone with natural conception after infertility and/or loss, at least from the pregnancy test forward.
Here’s a little look inside my head as I navigate those early weeks of pregnancy:
Transfer day is the day the doctor puts an embryo in your uterus. From this point forward, you can think of yourself as PUPO or pregnant until proven otherwise, but there is still a whole lot of proving that it was successful that must happen. No more talking out loud to embryos. Try not to think about it. Try not to read into twinges, possible symptoms, etc. It could all be a trick. Hold your breath.
You break out a pregnancy test. Two lines. Cautious excitement. Run to the store to buy a dozen more tests that you will strategically take over the next two weeks in an effort to confirm progression. Is the line darkening? Is the line darkening enough? Maybe I’ll squeak out a whisper to the embryo now while in my closet with no one around.
HCG blood level tests confirm pregnancy. The number seems good. Let’s compare it to every other person’s number even though they vary about as widely as the sea. Wait for the repeat to confirm doubling. Did it increase enough? What if it increased more? Is that a bad sign? I’m still holding my breath.
Pregnancy symptoms may or may not emerge. Am I sick enough? Am I too sick? Is that a spot of blood in my underwear? I never have any first trimester symptoms and the hardest thing is having no physical evidence to prove there is a baby in there.
Ultrasound day. Depending on your doctor and avenue to pregnancy, this could be anywhere from five weeks to eight weeks. A five-week ultrasound is agonizing. I am thankful for not having to wait longer for one, but also this is before heartbeats start, so I’m only getting half the answer. You see a baby (eek!), but you still have questions and wait again for more confirmation at the next ultrasound.
Six weeks and on ultrasounds, you hold your breath for a baby and heartbeat on the screen. Thump, thump, thump. Oh, this is a very good sign! You debate telling close family and friends your secret. But what if you come back next time and it’s gone? Let’s hold our breath a little longer.
Ultrasound after ultrasound is starting to assure you this is real. Baby finally gets big enough to find their heartbeat on an at-home doppler. It’s not recommended, but who are they kidding? You’re going to be checking this often for reassurance.
Finally, a tiny bump! And small flutters! More assurances. For many this anxiety can continue well into the second and third trimesters, but finally there is evidence that this is really happening, and you feel like you can take a tiny breath. Maybe this is happening this time! “Hello baby! How have you been? I’m sorry you haven’t heard from me yet. I’ve been really scared. But I am here. And I am so looking forward to meeting you!”