I'm pregnant. Help me stop freaking out?
October 21, 2011 12:03 PM   Subscribe

I just found out I'm pregnant. I'd like suggestions for managing miscarriage fears and my doctor's testing recommendation.

I had a positive pregnancy test this morning, after doing an intrauterine insemination with donor sperm two weeks ago. (I'm queer and my partner doesn't make sperm.) I'm really, really happy to be pregnant on my 6th attempt. In fact, I'm ecstatic. I keep saying to myself, "I'm pregnant!" to try to help it sink in.

So now what? My first instinct is to start reading everything in sight about pregnancy to start preparing for what's to come. But I know there's a good chance I could have a miscarriage (probably 25-30% as I'm in my late 30s) and I don't want to get my hopes up too much or freak myself out. I would appreciate advice on how to deal with this. What worked for you or your partner/friend to deal with anxiety in very early pregnancy?

I'm also trying to decide whether or not to take my fertility clinic's advice and go in Monday and next Wednesday for blood hCG tests. I'd prefer not to do this, since they told me that the main purpose of the test is to predict whether or not I will miscarry - but that there is no treatment to prevent miscarriage if dropping hCG levels indicate one is likely. I have a needle phobia and find such visits very stressful, and I know that knowing my hCG level will make me freak out and worry even if it's good. So I want to skip the test and just wait and see if I stay pregnant. The doctor's office is pressuring me to come get the test even though I don't want to. What should I do?
posted by anonymous to Health & Fitness (27 answers total) 9 users marked this as a favorite
Honestly, what worked best for me was just to try to keep my mind off it, which is very hard when it's your first pregnancy, especially when you've been trying for a while. There's nothing you can do either way, so just try to divert your attention to something else when the anxiety kicks in.

And on the "nothing you can do" front, I am with you on not wanting any tests that I can't act on. It's the same reason we decided not to screen for Down syndrome -- there's no intervention for that, so I said no even though my OB kept offering it. Just keep saying no and tell your doctor why. If s/he keeps pressuring you, think about finding a new doctor.
posted by chickenmagazine at 12:08 PM on October 21, 2011 [1 favorite]

Wait and see. In early stages the levels can change suddenly, and if there is a danger of miscarriage you'll find out before the blood levels come back from the lab. Definitely start taking prenatal vitamins if you're not doing so already. If morning sickness makes that difficult, one option is just taking the folic acid. Whatever you do, make sure you are getting the nutrition you need if you want to feel safe about your baby.

May the baby arrive in the right time!
posted by Deathalicious at 12:16 PM on October 21, 2011 [2 favorites]

First of all: Congratulations!

If I were in your shoes, I would probably refuse the test. I agree with chickenmagazine, if your doctor is overtly pressuring you into things you aren't 100% down with, it's time to kick 'em to the curb.

One thing I would recommend as a means of dealing with the fear of miscarriage is to keep this news close to the vest for the first trimester, during which miscarriages are more likely to happen. Obviously, take as much pleasure as you can with your partner in celebrating in this wonderful turn of events, but keeping it on the d/l might be a good idea. It has the nice effect of delaying the reality of the risk without the delaying the delight of the news. Like, if you hold off on telling everyone and buying all the fun little baby stuff, it can make it easier for you and your partner to spend time feeling giddy and happy and scared together. Then, when the riskiest part of the pregnancy passes, you can celebrate two things: Your future baby, and moving on into the safer zone!

[Obv, YMMV.]
posted by emilycardigan at 12:16 PM on October 21, 2011 [3 favorites]

it's hard. but luckily it's an 8-week or so wait. I thought of it as, "my job is to keep calm"; my SO's job is to be supportive. Rest (bedtime at 8pm is fine when you need it!), don't worry about any of the other planning parts of pregnancy, other than reading what you can/can't eat, and basic physical changes to expect.
posted by ejaned8 at 12:18 PM on October 21, 2011 [3 favorites]

I would ask them again about the options. Typically, you do a round of testing for abnormalities around 12 weeks as I recall. Then you can do further testing as warranted, terminate a pregnancy, or continue on and hope for the best. The only thing you can do is focus on yourself. Get enough sleep. Take those vitamins. Cut back on caffeine and eat well. I think it's good to be realistic and try not to go off the rails with excitement. Do some yoga and meditation and recognize that this is a process largely out of your hands. Congrats and good luck!
posted by amanda at 12:18 PM on October 21, 2011

Congrats! I'm a bisexual woman married to a woman and currently 18 weeks pregnant from donor sperm as well. I won't tell you my whole long haul because you don't need to hear all that, but I absolutely understand your fears of miscarriage.

You may not like to think about it, but something that helped me stay calm was the understanding that early miscarriage is your body's way of ending a pregnancy that was never going to be healthy anyways. It's your body doing the right thing to protect you and the baby that you will eventually have. There is nothing you can do to prevent or cause a miscarriage - all you can do is give your baby the best environment to thrive that you can - take your vitamins, try to relax, love yourself and your partner.

I celebrated every week that went by without a miscarriage, knowing that every week it stuck meant increased odds that it would stick for good. I got happy and anxious butterflies in my stomach, and went through every what-if scenario I could think of. There's nothing to do but wait, so whatever coping strategies you have to help you wait (with the exception of drinking, ha) are what you need to do.

If you are uncomfortable with the blood test, I say don't do it. Like I said, there's nothing to prevent a miscarriage, so the blood test can't do anything but tell you what you already know - you're pregnant. If you miscarry, so be it. The blood test can't change that.

Whether you tell people or not that you are pregnant depends on your own personality. I decided that if I did miscarry I would want the support of some close friends and family, so I told a few people. I waited until 12 weeks to tell the rest. That was the longest two months of my life, but I got through it, and you will too!

MeMail me if you want to talk privately - I don't know a lot of pregnant women in relationships with women and I'm sure we would have a lot to talk about!
posted by arcticwoman at 12:43 PM on October 21, 2011 [8 favorites]

Rereading the question I realize I made some assumptions about you and your partner's genders. I apologize. I just got so excited with the prospect of more pregnant lesbians/bisexuals. :)
posted by arcticwoman at 12:45 PM on October 21, 2011

Congratulations and best of luck!

With my first pregnancy, I let them test my hCG. They told me to be on the lookout for the cramping and bleeding to start. Instead, now I have an awesome 2-year-old girl. (And the pregnancy was totally normal.) Second time around, I skipped the hCG test, everything looked great at my 8-week appointment, and then I miscarried at 11 weeks. Point is, there is SO much going on in the first trimester, and so little of it that you can control, that I feel like there's no point worrying about the stuff you can't control.

And if you're leaning toward a minimal-intervention approach to this whole thing, you might look into seeing a midwife instead of an OB. Way more personal attention, way less alarmism. I'm really happy I made the switch.
posted by eleventy zillion at 1:05 PM on October 21, 2011 [2 favorites]

The point of the blood draws is to see reassuring doubling of HCG levels. If you're going to find the draw more stressful than you'll find the doubling reassuring, don't do it; as you say, there's nothing you can do anyway if the numbers don't rise.

You can run out and read books if you want, because as common as miscarriage is, so is eventual successful pregnancy. You are vastly statistically likely to need that knowledge one day! On the other hand, you can play this really low key for the first trimester if you want; get the list of foods to avoid, no changing kitty litter, eat well, and pick up the books when you're feeling more confident.
posted by DarlingBri at 1:06 PM on October 21, 2011 [1 favorite]

Yay!! Congratulations!!

I think you should take care of yourself. Exercise regularly but not strenuously. Eat well, but not for two. Sleep when you feel tired.

I also say you should daydream as much as you want. Window shop. Revel in all the cute baby things. Just don't make any purchases yet, when you pass the magic 12 week mark you'll still have plenty of time to spend lots of money.

You'll be heartbroken if you miscarry. It's not going to be any worse for you if you spend the time daydreaming than if you constantly told yourself to be cautious.

I say enjoy this pregnancy. Try to live in the now. If you are going to miscarry then there isn't anything you can do about it. Let it go and enjoy your little zygote while you have it.
posted by TooFewShoes at 1:08 PM on October 21, 2011

...Because the next thing you know it'll be a irritating teenager and you'll wish you were back to worrying about this!
posted by TooFewShoes at 1:09 PM on October 21, 2011

So, yes, there's not a lot you can do in the first trimester about miscarriages, they happen or they don't. However, besides low HCG levels, they also test your progesterone, and if that is low, that can cause a miscarriage and this is something they can fix with drugs (they are horrible drugs that double all the bad side effects of pregnancy, but in the end it's for a baby, so it's worth it). So I'd talk with your doctor about whether they want you to get just an HCG or that and progesterone and make your decision based on that. I'm not sure when they do what, but with my 2nd (and current) when I was spotting they sent me in for that and then put me on the fun fun drugs until the 12th week.

Otherwise, only tell the people that you don't mind having to tell if you miscarriage (ie. the people you want to help support you through that), and go ahead and be as excited as you want, or that your body will let you.

Also, start working on how to keep calm with needles, you're going to get a lot of them as you go along, they like using us prenant women as pin cushions.
posted by katers890 at 1:13 PM on October 21, 2011 [3 favorites]

2nding consider a midwife if you are the low-intervention type! I made the switch from an OBGYN to a midwife very late (35 weeks) and I really wish I had done it sooner -- the midwife was so reassuring and didn't stress me out like the OBGYN did.

I'm not sure what katers890 is talking about with all the needles -- I got one blood test early in my pregnancy and that was the only time I was stuck with a needle that I remember.
posted by rabbitrabbit at 1:19 PM on October 21, 2011 [1 favorite]

They can't make you take any tests you don't want to take. What are they going todo, tell you you can't have the baby?
posted by bq at 1:26 PM on October 21, 2011

It's your body - the blood test won't make the pregnancy stick better than without it, so why put yourself through all the stress.

I've been there - good luck and congratulations :)
posted by thatone at 1:30 PM on October 21, 2011

However, besides low HCG levels, they also test your progesterone, and if that is low, that can cause a miscarriage and this is something they can fix with drugs (they are horrible drugs that double all the bad side effects of pregnancy, but in the end it's for a baby, so it's worth it). So I'd talk with your doctor about whether they want you to get just an HCG or that and progesterone and make your decision based on that.

This is a very important point.
posted by ThePinkSuperhero at 1:48 PM on October 21, 2011 [2 favorites]

I spent the first month of my pregnancy terrified. I went into researcher overdrive and read every study I could find (there may or may not have been tables comparing my chance of miscarriage based on age and how far along I was). I read maaaany blog entries and far too many mum's forums - especially the ones about miscarriage. It was not, as you can imagine, terribly healthy for me...

Fortunately, by the second month, I reached saturation point and realised that here I had spent months in 'get pregnant' researcher overdrive and now, here I was, finally pregnant and still driving myself rather mental.

I got one pregnancy book (The Day-By-Day Pregnancy Book) and stopped reading blogs and forums. I stopped Googling and relied exclusively on that one information source (plus my GP/midwife).

I decided that, having spent months hoping to be pregnant, I was damn well going to enjoy being pregnant. If the pregnancy was destined to end in a miscarriage, I wanted to at the very least have pleasant memories of being pregnant.

I don't really regret being so worried during the first month - it is perfectly normal, especially for something you want so much - but oh! things got so much brighter when I stopped seeing this pregnancy resulting in a baby as THE MOST IMPORTANT THING EVER and celebrated that I got pregnant.

(Also, congratulations!)
posted by brambory at 1:57 PM on October 21, 2011 [2 favorites]

2 kids, 4 miscarriages. My first was conceived on the heels of a previous miscarriage, and they drew all kinds of labs, and my hCG was 10 times as high as they expected and not doubling and my progesterone was crazy low and I was spotting and cramping and everyone told me to brace for another miscarriage. . . except the high-risk OB who did an ultrasound to rule out an ectopic pregnancy, noted appropriate embryonic development such as it was, and said "Don't rule anything out. Numbers are numbers; babies are miracles." That particular miracle is now eating a Nutella sandwich and watching Dora in the next room.

Early miscarriage is devastatingly common, but it's still a minority. As for managing fears, I got nothing; I spent my entire first (keeper) pregnancy and half of my second scared witless. I personally WOULD do the testing, if only so they can find your progesterone level, because that's something they can supplement to help the pregnancy stick around if it's low. A strong beta with a short doubling time isn't a guarantee of anything, but it does help shift the odds.
posted by KathrynT at 3:28 PM on October 21, 2011 [1 favorite]

My OB was completely fine with me declining tests. He explained why he thought they were a good idea, but there was no pressure. He also kicked ass in terms of bedside manner and support during my horrendously unpleasant delivery. I think it has to do more with the provider's personality than their title...

That said, his office staff were assholes and I could totally see them pressuring me into doing a test that my OB wouldn't care that much about.

In terms of worry, I think a lot of it is the human condition.

Right now I'd think about whether you want to stay with your OB, and if not, find another provider. I'd also think about the nuchal translucency and other first-trimester tests for fetal problems.

Check your insurance coverage for these tests, too! It's important to know what prenatal care is covered and what is not.

Good luck!
posted by the young rope-rider at 4:21 PM on October 21, 2011

The thing about pregnancy, birth, and parenting is that terrible stuff happens sometimes. But it doesn't happen that often.

Once I realized that once I could stop worrying about one thing, I'd have to start worrying about something else, I started to relax. Because most of this stuff is not stuff you can control (though you do your best to improve the odds of things you CAN control), worrying about it is only going to make you miserable.

Enjoy! And congratulations. The odds are in your favor that everything will be OK, even if there are some bumps in the road along the way.
posted by rabbitrabbit at 7:51 PM on October 21, 2011 [1 favorite]

I'm totally neurotic, so I dealt w/my anxieties during pregnancy by trying to remain blissfully uninformed. I didn't scoop the litterbox, I took my vitamins, but I read ZERO books b/c I had to manage my anxiety somehow. (Oh, not true -- I read books on breastfeeding!)

Re: blood tests -
Others have mentioned that besides bHCG, they look at progesterone levels, & that low levels of progesterone are correlated w/higher chance of miscarriage, & that you can take a supplement (I did), so it might be worth it to have blood drawn for that purpose.

posted by oh really at 7:51 PM on October 21, 2011

I miscarried my first pregnancy, which had been a long time coming. Because it was my first, and because my mom had difficulty carrying, and because, as a health care worker, I'd seen a gazillion D&Cs, I thought I was prepared. I wasn't. It was a real blow, and it made my second (difficult, but full-term) pregnancy that much harder, emotionally speaking.

There's nothing that made it sweet bliss for me, but I'll put forward these things:

1. Know that pregnancies, especially firsts, sometimes will miscarry, and if it happens, it's not your fault. (You seem to have that down, but I thought it was worth reiterating.)

2. Know what to avoid (exercise that your body isn't accustomed to, certain cheeses/processed meats, unwashed veggies, etc.). Miscarriage can happen even when you do everything "right," but for me, it was important to be able to say to myself, "I did everything I could," even when it wasn't entirely rational.

3. When anxieties pop up, do specific things to address and reduce them. What mainly worked for me was to find something to distract myself with. Meditation and deep breathing may help. You can also dispute fearful or pessimistic thoughts. But mainly? Distraction was key for me.

4. Miscarriage is difficult, especially when you've tried so hard. You grieve. And then life goes on, and it's okay. You're okay. You survive the storm, and you come out the other side.

Best wishes.
posted by moira at 7:57 PM on October 21, 2011

Yay, a baby!

What you are feeling is totally, totally normal. When I found out I was pregnant with my first (totally planned, definitely wanted), I realized how it is that women do crazy things when they find out they are pregnant. It's scary! It's weird! OmgwhatdoIdo!? I felt this way when I found out I was pregnant with our second too (also planned, desired, etc, etc).

This feeling goes away. When you hear that little heartbeat for the first time, or when you feel the little bug moving around in there. Or maybe when a real-live baby comes shooting out of your vag (but I bet it happens way before then).

My best advice is to step away from the Google. You have a choice here: you can read all day about babies (or fetuses, whatever you prefer) that don't make it and what the odds are at any given moment, or you can focus on something else. Either way, whatever happens is going to happen: be happy and excited in the now. Also: baby-related message boards are evil and should be avoided at all costs.

Someone upthread mentioned a midwife. I can not second this harder. My midwife has been absolutely spectacular about spending the time to address everything that my partner and I are worried about, no matter how trivial. A good provider will not brush off or dismiss your concerns or fears, ever. Take the time to find someone you really love, it's worth it. I consider our midwife a part of our family and even when I am not pregnant, I see her often.
posted by LyndsayMW at 9:36 PM on October 21, 2011

As far as I can tell, the US is the only country that has all this HCG testing. It serves NO purpose in an early and apparently healthy pregnancy, *unless* the pregnant woman actually wants these tests (when it may be psychologically reassuring).

The stuff about being able to boost progesterone levels to avoid a miscarriage was not supported by any evidence last time I looked into it (about 2 years ago now). If someone can provide info to the contrary, then, sure.

Just distract yourself as much as you can -- read and watch fun things... Whatever happens, you will learn a lot about acceptance of things that you have no control over.

Good luck!
posted by 8k at 3:23 AM on October 22, 2011

Congratulations! No matter what, this is a big moment and I hope you get to enjoy as much of it as you can.

After two miscarriages and twenty years of being told I'd never have a baby without massive intervention, I was pretty gunshy when I realised I was pregnant a couple of years ago. I had the same initial reaction you (and others) describe here - I didn't want to relax into it or take it for granted. But I had to do something other than fret, like the folks here are saying (I didn't think to ask them like you did, though).

I decided (as several people here advise) that no matter how long I was pregnant, it was pretty amazing it had happened at all. I'd long considered the animating energy of life as a "spark", so I started thinking of the pregnancy as precious time with a visiting Spark that may or may not stick around to see the world this time. Maybe I was just a peaceful resting spot for a Spark that would go on to a different form instead of being human this time, or to a different situation than the one I could offer. I wrote a short letter to Little Spark, acknowledging that we may not get to meet each other but that I was going to love it for as long as it was with me and enjoy our ride together no matter how far it went.

From there on out, I just tried to make all the healthy decisions I could, have all the fun and lightheartedness possible, and eventually relaxed enough after the 12wk appointment to buy a onesie that I decided would be a memorial if something went awry after that point.

Meanwhile, I have the doctor telling me that as an older gravida (I was 38 at time of conception and 39 for most of the pregnancy) with a history of miscarriage that I should get all these crazy tests. I turned nearly all of them down. Definitely didn't do the hCG, because, as others said, what good would it do? I felt it would just ramp my anxiety up, and I didn't need more of it.

Ultimately, I was blessed with a lusty, beautiful wildcat of a daughter, and I'm so glad I let myself enjoy our in utero time together whenever I could. And if she'd moved on, if my body hadn't been able to contain her or she wasn't ready for this world yet? Being able to appreciate the time we had spent every day meant I'd regarded the Spark I was hosting and I became more and more at peace with whatever was going to happen. I know I would have grieved if she hadn't arrived healthy and sound, but it would have been tempered by knowing I'd put all the love I could into that Spark.

May your Spark remain and thrive, as well. If it does not, though, know that you are a safe place for it to rest for a while as it zips through the Cosmos.
posted by batmonkey at 9:37 AM on October 22, 2011 [47 favorites]

Mod note: From the OP:
Thanks everyone for the replies, they have been more helpful than you can imagine. Getting a bit of reassurance has been wonderful. At the moment I could use some help with figuring out this progesterone thing: if anyone knows of any good references or evidence-based recommendations on whether progesterone treatment can actually lower miscarriage risk, I would love to get that information.
posted by mathowie (staff) at 9:53 AM on October 22, 2011

As one of the people who initially recommended the progesterone thing, I went looking for supporting evidence and. . . actually couldn't find any. It seems like the answer from a lot of doctors is "Well, progesterone is cheap, it certainly doesn't hurt, and I don't want a woman to feel like there was something that could have been done that we chose not to do."

Also I realized that in my daughter's pregnancy, we didn't supplement my progesterone (9.8 at 5w3d) and she turned out absolutely fine, so. . . who knows.
posted by KathrynT at 10:08 AM on October 22, 2011

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