Lately, I've been thinking a lot about motherhood. About what it means to be a mother. About all the divergent paths that lead there, and the variations of motherhood that exist.

Brad and I conceived our first child long before Elliott. We were ecstatic about this baby. Envisioning what it would be like to transform into parents; how much baby proofing would be in order as every furniture corner somehow seemed sharper than we'd ever bothered to notice. I was a nervous wreck from the start. Worried about what morning sickness would be like, worried about taking the right prenatal vitamins, worried about everything. I don't know why I was so worried, I had experienced nothing that would lead me to be worried, but still - I was. Perhaps foreshadowing; in hindsight. 

At about week 5, I was in a meeting at work in the late afternoon and suddenly started feeling strong pain in my lower abdomen. My mind immediately went to thoughts of miscarriage. What does a miscarriage feel like? What do I do? Can I prevent it? Did I cause it? Oh God. 

I laid in fetal position the whole ride home (No one freak out - Brad was driving) and crawled into bed the minute we arrived. I wasn't bleeding so for whatever reason, I thought "It's fine. Everything is ok". In my naive mind, bleeding was the only indication of a problem even though, in my heart, I knew something wasn't right. 

The next morning, I called my doctors office and let them know what was happening. They told me to stay in bed and only get up to use the restroom or to go get my blood taken after they called in the orders. I hung up the phone, walked to the bathroom, sat down and felt the bleeding begin...

My mind and my heart were aligned - now they both knew it was bad. 

Still experiencing terrible abdominal cramps, I put on clothes that were somewhat acceptable for public appearance and drove my car to the nearest lap corp. My doctor wanted to check my HCG (Human Chorionic Gonadotropin) and progesterone levels. During the first trimester, HCG levels should double ever 48-72 hours and the progesterone levels should be at certain increments to maintain the pregnancy. So I walk in, sign in, and sit down - waiting, with my cramps and my thoughts, for them to call my name. They do, blood is drawn, small-talk is made, I leave, get home and crawl back into bed. 

Sometimes we are faced with heavy things that can't be resolved right away. I knew something was wrong, but the specific wrong wouldn't be confirmed for another 2 days when I would have to go back for the second blood draw. So I've got this heaviness, I've got this confusion, and I've got orders to stay in bed. What's a girl to do? Binge-watch Orange is the New Black - that is what a girl is to do. Nothing like some mind-numbing, auto-playing show after show, and embracing Netflix judgement in the form of  "Are you still watching?" to take your mind off of the heaviness at hand. 

I go back two days later to get my second blood draw. My doctor calls me that afternoon to tell me that the HCG did not double and the progesterone is not where she would like it to be. She wants to get an ultrasound and schedules one for the next day. 

By this point I'm all out of Orange is the New Black but chock full of fear and uncertainty. So I do what anyone in this situation would do - I move onto Unbreakable Kimmy Schmidt and allow Netflix to continue the passing of time that it's known for. 

The next day, Brad and I drive to the hospital and check in at the radiation department awaiting our turn for the ultrasound. Once in the room, the technician is doing her job and keeping pretty quiet. Not like they can tell me anything anyway, but I've always found the quietness to be immensely haunting. There are words floating in that silence.   

As she walks towards the door, she says to wait while she checks that she's captured enough images for the doctor. If memory serves, Brad and I sat in silence, awaiting her return. She comes back in, with the doctor who confirms that she needs additional images. So we start again and after a short bit, she says "I've got what I need, let me review them with your doctor. Sit tight." 

We wait. Again, in silence. 

She returns, and says ok - your Doctor would like to see to review the images with you. In my mind, I'm screaming "Enough, just tell me what the hell is happening with my baby?!" but aloud I say "Ok". My doctor's office is adjacent to the hospital so we make the short (but quite long that day) walk to her building. We go up, sign in, sit down and continue to practice the art of waiting. I have a Masters degree in waiting by this point. I can teach a class in waiting and be on track for tenure. 

My name is called and we walk back not to an exam room, but to my doctors office. The place where news is delivered, not babies, but news. She walks in shortly after us and sits down at her desk. She does not beat around the bush (which I certainly appreciate at this point) and says "Aubrey, you are having an ectopic pregnancy. Do you know what that is?" 

Me: ... no. 

Dr: It's when the fertilized egg implants outside of the uterus. Most often, it implants in the fallopian tube - as it is in your case. This means that the body can't sustain this pregnancy since the egg is not where it needs to be to grow. If left untreated, your tube can rupture which is life-threatening to the mother. 

Me: *silence* *staring blankly past doctor*

Dr: Aubrey, are you ok?? 

Me: Uhm, no. I mean, I feel the same physically but I am trying to process what you just told me. 

Dr: I know this is not what you wanted to hear, I'm sorry. This is not what any of us ever want. 

Me: What do we do now?

Dr: Well, if your tube has ruptured I will need to remove it. If it is just torn, the tear will heal on it's own and we can treat the rest with medication. So you can go home and *she looks at Brad* you can keep an eye on her for signs of internal bleeding which indicate a ruptured tube or *she looks back at me* I can admit you overnight, check blood counts and confirm internal bleeding or otherwise. Then, if necessary, we can have emergency surgery first thing in the morning to remove your tube or know that we are safe to continue with drugs alone.  

Brad and I look at each other - we both agree that staying at the hospital overnight is the smartest option. 

Me: Please admit me. 

Dr: Absolutely. I'll call them right now and by the time you walk over, they will get you set up in a room. 

We're in the room, I'm lying in the tiny bed wearing the scratchy blue gown. The nurse informs me that they need to draw my blood every 2 or 3 hours (I can't remember which - all I remember is the translation of that = no sleep) to accurately confirm internal bleeding (aka - tube rupture).  

We've come to the moment where Brad and I must decide about sharing our reality. I'm only about 6 weeks along at this point and we hadn't shared the news with our parents. Now, I'm in the hospital, facing a possible surgery that would remove one of my fallopian tubes, still trying to digest this final confirmation that we will never meet our first baby. 

I was pregnant but also not pregnant - simultaneously. It was surreal. 

Brad needs to run home to grab essentials for the night and for a potential surgery the next morning. We decide he is going to make the calls to our parents on the drive and let them know what is happening. My God, as I type this now, I ache all over again for Brad. Not only is he suffering with the loss of his first child, but he now has to make three of the hardest phone calls, in a row, and then rush back to his mirage of a wife in the hospital.

The state I was in was a joke. I was wavering between a world where I chose to create a fake reality and a world where I absorbed reality like a sponge. One foot in "Everything is fine-ville" and one foot "What the eff-town?". I couldn't have made those phone calls, not a chance.  How does that call even go?  "Hi Mom, Dad, you were going to be grandparents - but now you aren't." NO. STOP. I can't.  

The next morning my doctor comes in early to offer the news that I'm not bleeding internally - which means no surgery. This was a huge blessing. It meant my tube tore slightly, which will heal itself, and we can use drugs to ensure the fertilized egg doesn't continue to grow and cause any more damage. She advises that the HCG is dropping which means my body is taking care of the pregnancy by itself. Though we need to continue with blood draws so she can track the HCG all the down to zero. We get to go home - but I have to go in for blood every other day and take it easy.   

After all this hard, I must admit the next few weeks were so much harder. The cramps and bleeding persisted. This alone, I could've easily dealt with - helllloooo, typical every month for a woman. What destroyed me was what this all meant - to me. My interpretation of watching the HCG work it's way down to zero was really my baby dying inside of me. Day by day, little by little, he/she slips away.  It was cruel and inescapable. And it lasted far too long.  (I understand this is dark and intense but it's truly how I felt - and as you all know by now, this blog ain't no fluff piece!)

I received permission from my doctor to go out a week later. Brad and I had tickets to a play and I was really looking forward to a break in the harsh monotony. Brad left work early and is on his way home to come pick me up when my phone rings. It's my doctor. 

Me: Hello?

Dr: Aubrey, the HCG isn't going down like it should. We need to intervene so I need you to come to the hospital tonight. 

Me: Whoa. Uh, so does this mean my tube could still rupture?

Dr: Yes, so come up here. 

Me: ..Oh wow, ok..

I call Brad and let him know we won't make the play but have new plans. He arrives home, I get in the car and we head back into town. I remember every single bump on that car ride. Anxious that a speed bump approached too fast would result in one less female reproductive organ. Organs I prayed would be used to their fullest extent someday. 

The most commonly used medication for an ectopic pregnancy is methotrexate. This drug is no joke - it's a chemotherapy agent used for battling a variety of cancers as well as auto-immune diseases. Basically, it works by destroying rapidly dividing cells - methotrexate is the enemy of folate. Folate being essential to a developing fetus. 

Methotrexate is my doctor's game plan. But before I can be administered the drug, they tell me they have to make sure my organs can take it. It's pretty intense on the body so my liver, kidneys and other critical functions needed to be strong enough to handle the impact of methotrexate. 

So more blood is taken, more waiting occurs and then hours later I'm given the green light. Two shots in two butt cheeks later, and we wait again to see if I have any side effects. Boy, that's always fun isn't it? Our bodies are basically walking experiments where we just wait to see what happens or doesn't as a random chemical is absorbed. I always ask that they do not tell me the potential side effects because, let's be real, I will automatically feel whatever they say might happen. I'm busy - let's save the hypochondria for another day shall we. 

After no side effects, we get to go home. The blood tests continue for a week or so more and the HCG eventually disappears... 

I have a follow up ultrasound around what would be week 9 or 10 to confirm my tube looks healthy and nothing remains of the fertilized egg (as they say) - nothing remains of my first baby (as I say). I remember going back to the radiation department. I'm checking in to confirm my baby is gone, while the women around me are checking in to confirm their baby is thriving. I'm certain I was the minority scenario because upon check in they ask you "How far along are you?". You fight tears and reply "I would be 9 weeks" with an emphasis on the would. They offer an embarrassed and sorrowful look as they ask for your insurance card. 

Pregnancy is beautiful and pregnancy is brutal. It's brutally beautiful. It's a path that is different for every woman; for every couple. It's a path for which you can't prepare. Well - besides boycotting pants with zippers/buttons almost immediately after a positive pregnancy test. That's really the only preparation you can truly rely on.   

I've been drinking up this quote, lately:

If I'm being completely honest, which is a big goal of this blog, I am scared. I am scared to start down the path of motherhood again. Scared to try for siblings for Elliott. What if I lose another baby? What if I have another ectopic pregnancy and lose a tube this time? What if I do get pregnant and he needs a trach too? What if she also has a cleft lip & palate? What if he has Down syndrome like his sister? What if she needs countless surgeries? What if he needs this and she has that?

I can't fit in another therapy, doctors appointment, specialist, surgery, anything. I can't possibly give what we give to Elliott to another baby. I just can't. 

It's evident I am not living by my hopes. I am without question living by my fears and have been since my first baby. It's a sad state to dwell. For example, when we learned of Elliott's small chance for survival because of her heart defect, we did not create a nursery for her and decided to forgo baby showers. While I can't say I would've made a different decision if faced with the same circumstances again; it was devastating not to create a room for my baby or to celebrate her in ways I'd always dreamed. Devastating. Would it have been more devastating to design an intentional space filled with gifts just for her - never to be used? I don't know.

Maybe.

Maybe not.  

My point is I missed out on the joy in order to protect myself. I guarded my heart to prevent it from breaking. So, in my life, I'm protected from the hurt, but missing out on potential bliss. I'm not sure I want to live this way any longer. Which is better for the soul - the beauty that could be or the bypassed brutality? 

I can confirm the answer is the former. 

I want Elliott to have brothers or sisters. I want them to experience all the wonder she has to offer and I want her to experience the vows only a sibling can pledge. I hope to have the braveness to battle any additional brutal and pray, with every ounce of my being, to experience the beauty. *she zips up her big girl pants*

Here is to all the mothers who hold a child in their arms or in their hearts. Here is to the mothers who decided motherhood was not right for them and to leave it to others while they become beloved Aunts instead. This being one of the most sacrificial and, ironically, motherly acts a woman can make is to know herself well enough to know she is not designed for the traditional motherhood path. (I know several of these motherly woman and have endless admiration for them) Here is to the mothers who've endured endless medical intervention to conceive and hold their babies. Here is to the mothers who made the brave decision to give their child to another to make her a mother. Here is to those mothers who accepted that gift with open arms and a grateful heart. Here is to every mother, everywhere. I am honored to travel this path with each of you; may we all experience the beauty in some way or another. Happy belated Mother's Day 2018. 

Until the NexT21,

Aubrey