Deliberating Delivery

Planning for a surrogacy delivery is complicated in the best of situations. Where will the delivery occur? How can it be sure that the Intended Parents will be present? Who will be present? What interventions will and will not be allowed? What is the birth plan? Delayed cord clamping? Who will hold the baby first? What risks are involved and are they tolerable? I could probably have devoted an entire blog to the decisions that were made in this regard. 

The simple version is this: We both wanted a home birth for C (and for me). We both wanted to be followed by midwives and to have a doula's support during labour and delivery. We both wanted a water birth, with no intervention, delayed cord clamping, and immediate skin-to-skin with me. 

The complications: C lives 1.5 hours from us. We are planning a home birth but should there be complications a transfer to hospital would occur. So, whose home would C birth in? We considered both of our homes. I personally wanted to plan a delivery in our home. I liked the idea of having my midwives, who have supported me through all three of my own pregnancies, being present. It seemed full circle to me. I liked the idea of being in our home because I would either be recently post-partum, or very pregnant. I believed that being in my own home would be more comfortable either way. Above all of that, we needed to try to plan for C's emotional well-being. I was cocnerned that if we left too quickly, she might feel used or overlooked. I thought that if she was in our home that she could stay as long as she wanted, and leave when she chose, giving her some power in ending that part of the journey. Luckily, we all agreed on this. 

Once this was decided, a new complication was to be considered. What if C was in a quick moving labour and she is unable to reach us in Pembroke? That would require planning for delivery in her home, just in case. Given that there could be complications, we needed to plan for a possible hospital delivery - in Pembroke and Ottawa. All of a sudden, we are planning for a possible delivery in four different places. The planning for hospital births, as it would turn out, became particularly complicated. 

Another element of the planning is the emotional side, for C and myself. There is no way to know what C's experience would be, nor my own. I felt insecure. I was concerned the baby would want and love C naturally; I did not want them to be near each other. I wanted to catch the baby and hold it until I was convinced it knew I was Mummy... but, I could only imagine how important it would be for C and her family to see and hold the baby. 

We found a wonderful, warm, understanding doula who had twins of her own to attend both of our births. She had tears in her eyes when I spoke of Maggie and Patrick so I knew she would be a compassionate and supportive person to be with me. C also decided she wanted this doula present. We sat and discussed, ad nausea, all the potential outcomes for labour and delivery. Where we would be, who would go into labour first, etc. 

Ultimately, we had to approach late pregnancy and due dates with flexibility; there was so much that we could not know. In the mean time, I pushed myself to engage in the planning discussions without being overcome with fear that we would not reach that time with healthy pregnancies. 

xx

The Incident

When another woman is pregnant with your child, there is a strange distance from the pregnancy. I was both excited and removed. I found it to be an exercise in imagination; I had to keep reminding myself that we had another baby on the way. The opportunity to be more present and involved with the pregnancy was always welcome - to touch her growing belly, to see or feel baby move, and to attend ultrasound or midwife appointments. 

It was with some distance, and to be honest, some fear that I was too emotionally removed from the pregnancy, that I attended a midwife appointment with C around 20 weeks gestation. Her midwife, T, had a room that was made cozy with stacks of books and artwork on the walls. There was a futon with blankets and pillows positioned across from T's computer and chair. The office felt home-like and comfortable. This was my first meeting with T and as much as I was happy to attend, I also was apprehensive. What if there is no heartbeat? What if the baby or C are unwell? Always, what ifs. 

T sat down, a warm smile on her face, and said "So C, how are you? No more bleeding?". C looked like a deer in headlights, her head slowly turned towards me. I froze. My eyes stuck wide open and staring at C for an explanation. Everything became slow motion. C was immediately reassuring me and although I could hear her, my body was still filling with a paralyzing fear. I realized I was not breathing. I gasped for air, burst into tears, and had to focus so as to not become caught up in hyperventilating. C reassured me that it had been a minute amount of blood, only one morning, and that she had attend the hospital and had an ultrasound to ensure the baby was healthy and safe. She explained that she had not wanted to scare me without due cause and so had not told me when the bleeding occurred. She explained that everything was determined to be fine and so she did not tell me about it. I could hear her and I was slowly processing that the baby was fine. I could also hear myself thinking that she is supposed to be the 'sure thing', the 'safe' pregnancy, hope. It did not matter that I had not been told and it did not actually matter that it had been a false alarm. I was terrified. And in that moment, I knew. I might be physically removed from the pregnancy but I was definitely emotionally invested. We then listened to the baby's beautiful, happy heart beat and I cried. I cried in relief and love.

After the appointment C asked that we speak quietly. She expressed her concern that I might be angry or upset that I had not been informed about the bleeding. I share this part of the story because it is yet another testament to C's kind heart. She had not told me out of consideration or protection. She wanted to address any potential tension between us. Perhaps I should have been angry. I do not believe there should be secrets relating to my baby. However, in all honesty, I was not angry. Even in speaking with a friend afterwards during which I indicated that I would not want it to happen again, I said it with a sense of ambivalence. I believe that above all else, I was thankful that C had taken all steps to ensure the baby was safe and healthy. It is what it is. 

xx

Complexity of human emotion

Looking back on both pregnancies, what sticks out was the emotional similarity to that of my pregnancy with Maggie and Patrick. When I was on bed rest I spent my days swinging between hope and fear, joy and grief. Each day brought me closer to viability and babies surviving, but I also knew I was a time bomb, sitting and waiting. Although the details are different, the experience was the same this time, with a couple complicating factors: work and C.

While on bed rest, my life was the twins, and my job to help them to live. Nothing more was needed of me. I lived - we all lived - day to day. But, this time I had a job. My co-workers and clients were not going to pause life while I swayed between hope and fear. It was terrifying to consider that the babies might survive; it seemed like I might jinx things by assuming as much. Yet, my belly grew, as did C's. Clients asked me who would replace me and work requested I begin planning for my maternity/parental leave. Real life required that I plan for living babies, while the part of me filled with fear screamed to avoid it. 

But, to be fair, I am not always so self-aware that I think like that every moment of the day. I went about my daily tasks and began planning how to transfer clients and wrap-up paperwork. I sometimes felt excited to be planning for the arrival of the babies. I felt normal. It was usually in those moments that fear would surface, popping up forcefully, pulling me back from the danger of 'normal'. I would remind myself that anything could happen, even if it was not PPROM, it could even be worse.

The other factor was C. She is hope, yet I did not feel so safe as to walk around arrogantly assuming that she/we were immune from disaster. Throughout my pregnancy I spoke with 'ifs' and knocked on wood; people do not like that. I did not fill the 'glowing expectant woman' profile. People corrected me, rolled their eyes, reassured me... and C's existence gave them more reason to challenge my habits. I am not suggesting that my anxious thinking did not need to be challenged; it did. However, it was my experience that having a surrogate meant to others that my thinking/behaviours were some how less valid. 

Fear, doubt, grief - none of these are how I wished to approach my pregnancies. It meant that I delayed planning for anything; no nursery, no clothes or hospital bag, no van... when I did allow little moments of this I hid them in drawers or would need weeks worth of recovery time. It meant that I avoided pre-natal yoga until my third trimester even though I wanted to start earlier, and inquired about the cancellation policy before paying - just in case. 

Negative or not, functional or not, that is me, I guess.

xx