What happened was what scientists now know to be a normal pregnancy for a woman with PCOS. That is, difficulty conceiving, medical support required to avoid a miscarriage, high blood pressure and its associated pre-enclampsia issues, a higher rate of insulin dependent gestational diabetes (from very early on) and a higher c-section rate. Hey, I know it sounds messy, but given that I’ve been through two pregnancies like this in my life this just feels like normal. I’d like to say (like the ad) “this is normal, I’m built for this, bring it on!” But normal is a relative concept.
Normal. I normally get out of bed and before I have a coffee or anything to eat I get out my glucometer and take a fasting glucose reading. That is recorded in a notebook I discuss with my endocrinologist on a regular basis. Then, I get a needle out of the fridge, dial up my current insulin dosage requirements, and find a juicy piece of flesh on my torso to inject. Depending on how controlled or uncontrolled my sugars are at this stage of the pregnancy, I might need to eat something incredibly low GI like yoghurt and muesli. At other times in my pregnancy I need to boost my sugars and avoid a hypo, so I might eat two bowls of cocoa pops and a popper of sustagen just to make it through the next two hours of the morning school run.
About three or four months into the pregnancy I had to give up walking to school altogether because of the number of ‘hypos’ I was having. I would get half way to school, experience the uniquely light-headed nausea that I learned to associate with low blood sugars, and sit down at the first opportunity to check my sugars. If they were low, I had to eat or drink something high GI and fast. That was usually a handful of black jelly beans from my stash. Black, because I don’t really like them and therefore am not tempted to eat them at other times of the day. They taste more like medicine than a treat. Sometimes I bought a can of sugary soft drink from the nearest cafe. My fear of hypos and the harm they might do to my baby soon stopped me walking to school.
Normal. During the first 3 months of my pregnancy I was on progesterone pessaries twice a day to support the developing placenta. This treatment is usually preserved for IVF patients but was given at my request because we had no idea how capable my polycystic ovaries would be of supporting a pregnancy. Dr B was happy for me to take these pessaries for 3 months. They involved insertion in the [ahem] downstairs area and laying still for an hour, morning and night. I usually took the night time one at bed time and then tried to find a window of opportunity approximately 12 hours later for the morning one. I enjoyed this enforced rest since I was so tired and nauseous in the first trimester anyway.
Normal. Frankly, I think my second trimester was as normal as anybody else’s with a little more insulin thrown in for good measure. The highlights were the ultrasounds and discovering the baby’s gender. Oh, that and we discovered our umbilical cord had only two blood vessels instead of the normal three.
Normal. Third trimester saw a return to morning sickness, a deep nausea that seemed to settle by about 11am each day. It also saw an elevation in my blood pressure and two pre-enclampsia scares requiring hospitalisation. Pre-enclampsia is a nasty condition that can affect pregnant women and damage their liver and kidneys. The main way to treat it is to deliver the baby. The symptoms that are most worrying for the doctors are problems with vision (eg. blurry vision, double vision, flashing lights in front of the eyes, dark spots in front of the eyes), high blood pressure and protein in the urine. The sudden swelling of the limbs and face can also be a sign of pre-enclampsia.
For several weeks of my third trimester I was stressed out. I was tested every week for the presence or development of pre-enclampsia. Every week I wondered if this would be the week that my baby would be delivered. That was hard. I prayed over and over to God for a calm planned birth. Because I was insulin-dependent, I knew I would be required to have a c-section birth. That was fine. I was cool with that. I just wanted it to be planned and calm as opposed to an emergency.
Normal. Most women can breastfeed their baby but it is known that women with PCOS struggle to produce enough milk. Women with gestational diabetes are known to be slow in their milk let-down. It can be 5 – 10 days after birth (sometimes even longer) before their milk comes in. Rather than experience the devastating disappointment of my first pregnancy when I was unable to feed Grace, I have been seeing a lactation consultant. She is helping me to develop my milk supply even before the baby is born. For the past three weeks I have been expressing colostrum and storing it in the freezer. This will be fed to our baby until my milk actually ‘comes in’. Due to persistent hard work on my part, I am currently producing around 10 mls of colostrum every day. Hopefully, once bub arrives, this will translate into an adequate milk supply.
Right now I am 36 weeks and 4 days pregnant. I had a series of blood and urine tests on Monday. Last Friday I had an ultrasound. Today, I just visited my obstetrician and he has decided my baby is to be delivered next week in a planned caesarean section. He has made it clear that next week is the latest our little bub will be delivered. He has also explained that I will be administered steroids to develop the baby’s lungs for two days before the birth. Those steroids are known to play havoc with a diabetic’s blood sugars, so I will be self-monitoring with some help from my endocrinologist. I will be treating my sugars appropriately with insulin or glucose (black jelly bean, anyone?) as required.
There are so many things I have been through that are completely normal for women with PCOS. They constitute a normal pregnancy. [Note to Hachette Livre: Maybe you could engage me to write a pregnancy book appropriate for women with PCOS. We represent around 15% of all women and all those ‘normal’ pregnancy books don’t tell it how it is for us girls.]
So next week, I will have my second child. I will rejoice in his miraculous arrival. I will delight in his baby blue eyes because all babies have blue eyes for the first little while. I will also rejoice in throwing all my insulin pens, sharps and refills into the bin. I will rejoice too, in watching my beautiful henna belly fade away – according to Indian tradition I am not to resume housework until it has disappeared.
After my friend Simone painted my belly with henna yesterday, I prayed a blessing over this little child and also declared it for my beautiful Gracey too.
It’s taken from Isaiah 54:
13 All your children will be taught by the LORD,
and great will be their peace.
14 In righteousness you will be established:
Tyranny will be far from you;
you will have nothing to fear.
Terror will be far removed;
it will not come near you.
15 If anyone does attack you, it will not be my doing;
whoever attacks you will surrender to you.
God bless my miraculous babies, both of them, and give this little baby a safe passage into the world.
In Jesus Holy Name,