Pregnant again: What I did (and didn’t do) differently

Let’s get something out of the way first, as I appreciate the post heading here is rather click-bait-y, this isn’t going to be a post that offers easy answers. Yes, I’m pregnant again, and, yes, we’ve made it to 22 weeks so far (and counting…every agonising day and tremulous kick). But there’s been no ‘a-ha!’ moment; no ‘one weird trick’; a consultant hasn’t suddenly been able to pull a wonder pill out from under a sleeping rabbit in a hat. Even so, since announcing I was pregnant for the fifth time a few weeks ago I’ve found that one of the first things people ask me is: what did you do differently this time?

It’s a fair question. After all, it’s exactly what I would want to know, too, were it someone else. As one miscarriage became two miscarriages, became three, became four…I tore through the internet looking for stories of people who’d had successful pregnancies after losses – and what, if anything, they’d done differently when it finally ‘worked’.

So I think it’s only fair that I try to give the question a proper answer. With the major caveat that I am not offering advice or holding myself up as some sort of paragon. For a start, I still feel there is a long path ahead of us and we are by no means out of the woods yet (part of me feels that the very act of writing this is jinxing things, inviting the scorn and spite of the universe as I type).

Processed with VSCO with c1 preset

What’s more, as a general rule of thumb, I try not to dwell on these pages on what exactly I’m doing or not doing in our efforts to bring home a baby. I am not a doctor or an expert in anything (bar Harry Potter trivia or Gilmore Girls plotlines). I also know too well how seductive it can be, in the absence of any other answers or hope, to read the musings of a stranger on the internet about their radical lifestyle overhaul or battery of private medical tests and swallow it whole, as a prescription for success. Believe me, I’ve been there.

The not-so simple answer to what I’ve done differently this time around is ‘some things’ but also ‘nothing, not really’.

I didn’t have any new tests or procedures. And I didn’t make any major changes before we conceived this time. I kept taking the basic (and I really do mean the cheapest of the cheap, supermarket basics range) folic acid that I’ve been taking for the best part of four years. I didn’t change my diet. I am not gluten-free or vegan or vegetarian. I didn’t quit sugar. I ate real, full-fat dairy and (a little) red meat. I still had the occasional take-away and I didn’t worry about whether things arrived in plastic containers (at least, not from a fertility point of view). Unlike in the past, I still drank a little, though not much – probably no more than three glasses of wine or G&Ts a week. I vaguely tried to avoid alcohol post-ovulation, but I was by no means obsessive about it. I think I had a glass of wine the day before I got a positive pregnancy test this time, in fact. I did yoga once a week and carried on running, although I cut down on my miles and stopped signing up for races.

The biggest change – and it is potentially a very big one – was that once I was pregnant, I persuaded our NHS recurrent miscarriage clinic to let me take progesterone this time, on a ‘just in case’ basis.

Previously, all the consultants we’ve seen have been incredibly reluctant to prescribe anything at all, on the basis that all our results have been normal. But I knew that a large-scale, high-quality research trial last year had shown that taking progesterone increased the live birth rate for women who have had more than three miscarriages – in this particular group of pregnant women involved in the trial, 72 per cent of those who took progesterone went on to have a healthy baby, compared to 57 per cent of women in the placebo group (i.e. who were given pills with no active treatment in them). The researchers concluded that this was a substantial and significant benefit. There was a slight benefit for women who’d had one or two previous miscarriages, but the evidence is not as compelling. (You can read more about the trial, which was funded by Tommy’s, here, and the full scientific paper is available to read here).

The specific dose used on the trial was 400mg (as two capsules per day), and women took it up until 16 weeks – so this is what I did, too, starting after our first appointment, at seven weeks pregnant.

Progesterone supplements are not especially pleasant to take. They’re a pessary for one thing, which horrified Dan when I explained that I couldn’t take them orally, that the tablets had to go in my vagina (think cartoon-character eyes-on-stalks on his part, as we waited in the hospital pharmacy). Frankly though, after two general anaesthetics and an interminable amount of internal probing and prodding, a twice-daily encounter with a pen-lid sized capsule of hormone-infused vegetable fat is the least of my worries at this point.

They do make a real mess of your underwear though. And side-effects can include headaches, bloating and mood swings – of course, it’s hard to separate out whether these are caused by the supplement or by the pregnancy itself.

I’ve since learnt that it’s also possible that a bleed I had around the 8-week mark was caused by the pessaries irritating my cervix. This was alarming to the point of psychological torture, given that this was the exact stage our previous three pregnancies have failed, and that the bleeding looked identical to the start of both of my natural miscarriages. For a little over a week, I was completely convinced we had lost another baby and we went to our nine-week scan braced for bad news.

It was only after I’d had time to accept that the little bubbling bean we were shown on the ultrasound screen really was real – after the last tears of relief had been wrung out of me, after the sonographer had confirmed there was no sign of a bleed from inside my uterus – that a quiet anger crept in that no one had thought to mention the possibility of bleeding as a consequence of taking progesterone.

I should probably say, at this point, that progesterone is something I had to ask for specifically. I don’t think it would have been offered to me if I hadn’t. It should also be said that the best evidence for progesterone is in women who have had three or more previous losses and are experiencing bleeding again in their current pregnancy. (Whereas I didn’t get any bleeding until  after I started on the progesterone, confusingly).

With this in mind, I was well aware that it could make no material difference to us this time, other than offering a kernel of comfort, knowing that at least we weren’t ‘doing the same thing over and over again and expecting different results’. That much-quoted definition of madness.

My level of faith in the pessaries would pendulum-swing on an almost daily basis, lurching between a near-ravenous belief that the progesterone was all that stood between us and another miscarriage (invariably this would be on days where I’d forgotten to take one of the capsules, or taken it slightly later than usual) and, alternately, a cast-iron conviction that it was making no difference whatsoever, or, at best,  was just delaying the inevitable.  As I said, there are no wonder pills.

So that was the ‘something’, now here’s the ‘nothing’ part.

When it came to everything else, I tried to remind myself that I’ve done it all ‘perfectly’ in previous pregnancies and things had still gone to shit. And, on that basis, this time, there should be no onus on me to do anything other than the minimum of good pregnancy behaviour.

I carried on using all my normal beauty products and toiletries. I kept painting my nails. I kept an appointment for a facial, booked pre-pregnancy test. (Though I did dodge the hairdresser’s completely until the second trimester, unable to overcome my fear of being sat that close to hair-dye chemicals for any prolonged period of time).

I still ate runny eggs. And smoked salmon. On a very brave dinner out I ordered tiramisu (raw eggs, coffee AND alcohol). Though, to be completely honest, for the first 12 weeks, my diet was largely made up of Tuc biscuits with cheese, salted crisps and peanuts. Salted anything, really. My fruit and vegetable intake took a dive off a cliff, as I felt too sick. I didn’t drink coffee – not at all, not even decaf – until around 15 weeks, but only because even the smell turned my stomach. Make of that what you will.

I did stop running post-test and, on the advice of my teacher, I also stopped yoga for the first trimester. There is no medical basis I know of for either of these decisions, it was purely about managing my anxiety (and from about week six I was too tired anyway).

Another thing I used to beat myself up about after our previous losses was my stress levels: the strain of working 50-hour weeks, sometimes not leaving the office until 9pm or later, and commuting for up to three hours a day. Admittedly, a big chunk of that stress has gone from my life now that I’m freelance. This time round, I’ve had the luxury of making sure I could get enough sleep, rather than dragging myself up for the 7.12 train. But I did still have deadlines to meet, projects to juggle and tax returns to do. And, of course, throughout the whole of the first trimester, I was trying to co-ordinate a complicated house move. So I would be lying if I said I was entirely un-stressed (and that’s even before we account for the stress of believing you could lose this baby too, at any given moment – a whole other post, for whole other day).

I repeat, I’m not sharing any of this as ‘do’s’ or ‘don’ts’. I suspect a lot of my choices were largely meaningless. Instead, I hope this post can function as a sort of pressure-valve for the pregnancy-related perfectionism that can build up after loss. I hope it shows there is no such thing as a ‘perfect’ fertility diet or pregnancy lifestyle (beyond the very basics). I hope it helps quieten that weasly inner voice that likes to shout ‘blame’ at you whenever it can.

I’m aware that a more comforting answer from me, at this point, would have been to say that it has all felt different this time round. That I ‘just knew’. That there were signs. That I was more sick, more tired. But it would be a lie. For the first 12 weeks, I kept trying to read those runes myself. I willed the morning sickness to be worse. Because surely that would mean something. Every so often I’d convince myself that I didn’t remember feeling this bad when I was pregnant before. And then just as quickly I’d recall the piles of ginger biscuits I went through in pregnancy number two. Or the time I almost threw up on the tube, gagging on a stranger’s aftershave, on my way to the scan that diagnosed miscarriage number three.

As I said, there are no easy answers. There is only inching yourself along, cautiously and carefully, eyes as open as you can bear to keep them, on a tightrope across the unknown.

 

 

 

21 Comments

  1. I am so so happy for you and I hope your pregnancy continues smoothly. What a lovely bump you have! A beautiful photo of you.
    Our rainbow baby arrived on Christmas Day and I feel so lucky every day for our little man. Pregnancy after miscarriage is so hard though- so much anxiety and worry. It’s so hard to relax and trust things are going to be ok. My friends who’d been through losses and then had a successful pregnancy were the best support- hope you have a good support network. Wishing you much happiness. X

    Liked by 1 person

  2. So happy you have this pregnancy and it is progressing so very well. I didn’t know about the hormones, we had four miscarriages too and the thing that we changed was where we lived, moved to the country and took a chill pill and talked to the cows in the garden, that worked for us!! Good luck, try and enjoy as much of the experience as you can now cx

    Xx

    Liked by 1 person

    1. Ah that’s lovely to hear. We’ve done something similar (as well as the hormones)… moved from just outside London up to the countryside. Life is definitely taking on a much slower pace for us now, which helps. (Though I don’t think I’ve ever been accused of taking a chill pill successfully!) XXX

      Liked by 1 person

  3. Congratulations!!! I’m so happy for you 🙂 🙂

    I’ve often felt your life had an eerie parallel to mine when reading your posts and experiences and this is no different. I’m 17 weeks pregnant after 3 miscarriages…my recurrent miscarriage clinic put me on aspirin and progesterone (yuk yuk yuk, I hated that stuff). In my first 3 pregnancies I could always tell I was going to miscarry when my pregnancy symptoms disappeared / never appeared.
    This fourth pregnancy was virtually symptom free, I wasn’t nauseous once, just a little tired but nothing crazy, barely had sore boobs, my boobs didn’t feel ‘full’, I simply didn’t ‘feel’ pregnant at any stage of the first trimester. Every scan I would simply stare at the screen in disbelief, I was so sure this pregnancy couldn’t be real/healthy, yet here I am in the second trimester… Some things just don’t make sense I guess.

    Fingers crossed for the next few months X

    Liked by 1 person

    1. Congratulations to you too! I’m so glad you’ve said that about your symptoms (though I fully appreciate how difficult that would make it to have any sort of faith) I used to drive myself mad reading other people’s theories about how symptoms were notably worse in successful pregnancies etc. But it really does seem to vary wildly person to person. Keeping everything crossed for you too. xxxx

      Like

  4. I am so happy for you, like many others your words have given me great comfort as I went through two miscarriages, three erpcs/mvas and then a hysteroscopy a year ago due to Ashermans syndrome as a result of them. Our rainbow baby was born 8 weeks ago. I was on a natural killer cells protocol (which included progesterone) for my 3rd and successfully pregnancy as this was offered on the NHS to me by my local hospital; I’ll never know if it worked or not but I felt I had to give
    give it a go. Pregnancy after miscarriage(s) is beautiful but very scary. Thank you for putting into words what so many others feel. I hope you have a smooth and boring remainder of your pregnancy x

    Liked by 1 person

    1. Thank you…I’m so happy to hear about your rainbow – and that you were offered progesterone (it does seem like there’s been a bit of a sea-change since the PRISM trial published its results). And you’re so right, it is beautiful and scary all at once. xxx

      Like

  5. Congratulations Jennie! I’m so happy to hear this, and I hope you enjoy a happy and healthy rest of your pregnancy! (And congrats on the house move too!) X

    Liked by 1 person

  6. Congratulations Jennie! I’m so happy to hear this, and I really hope that you enjoy a happy and healthy rest of your pregnancy! (And congrats on the house move too!) X

    Liked by 1 person

    1. Thank you… trying to find the little things to enjoy, as and where I can. If it makes any sort of sense at all, I do really love being pregnant, alongside all the anxiety and everything else. xxx

      Like

  7. This has given me hope today, I’ve started on progesterone today… pregnancy 4/week 6 following 2 missed miscarriages and 1 blighted ovum. It’s so hard to stay distracted with such a long road to go but this is just what I needed to create a bit of hope!! Thanks so much!

    Liked by 1 person

  8. Congratulations, beautiful photo and beautiful bump! This website is a treasure, such a help during the loneliness of trying to conceive. We’re on month ten (which is not much really), and I had a chemical pregnancy in April – not even a ‘proper’ miscarriage…. Don’t feel like I can talk to anyone because it doesn’t feel bad enough or something. So it’s really great to read all your posts and the comments from others here. Best of luck and I hope you have a really safe and happy rest of pregnancy xx

    Liked by 1 person

    1. Thank you! I’m glad the blog is helping, too. It took us about ten months to conceive the first time and I sympathise… it felt like an eternity at the time. And for what it’s worth, I really wish the term ‘chemical pregnancy’ would go away and we’d call it what it is – a very early miscarriage. I don’t think it makes the disappointment and sadness any easier to deal with, it just makes people feel worse. You are still allowed to grieve for it. Sending you lots of luck and love. Jennie xx

      Like

  9. I really needed this post today! Found out im pregnant after 3 miscarriages and 1 missed miscarriage. Taking progesterone too! I have everything crossed but the fear is definitely in my mind already. Thank you for writing this X

    Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.