I saw an MFM on Tuesday to go over my records, talk about what happened, and ask questions about a potential future pregnancy. I didn't really feel emotionally ready for this appointment, but I felt compelled to do it partially in the hope of helping me process the whole big trauma.
The MFM immediately expressed sympathy for my loss and acknowledged how difficult this whole thing is. She was very caring, and she was also very surprised that I made an appointment with her so soon after losing Molly. I had mixed feelings about doing this; on the one hand, I wanted to talk about what happened and understand more because the whole experience was very traumatic and I'm still trying to figure out and accept what happened. I also feel pressure due to my age and other factors about not waiting too long before trying to conceive again. On the other hand, I'm not emotionally ready *at all* to try for another baby because all I can think about is having my sweet baby Molly back.
There were several times when we were going over the events leading up to me developing HELLP that she seemed surprised that my previous OB missed certain clues and wasn't more prompt in intervening. However, then she'd mask her surprise and stress that even if they had been more vigilant it probably wouldn't have made any difference. She told me that obstetrics is far from being an exact science and apologized that there wasn't more that could be done.
And she said that, though ACOG doesn't currently recommend testing for underlying clotting and immune disorders due to the fact that there just isn't concrete evidence of a link, she doesn't see the harm in looking into these things; so she is sending a recommendation to my new ob/gyn about what tests to order. More than these things, though, she was concerned about my family history of high blood pressure. Even though I had low blood pressure before the pregnancy, she said it's likely that the pregnancy unmasked my genetic tendency for hypertension and that it was important to make sure my blood pressure was controlled before ttc. My blood pressure still hasn't returned to what it was before I got pregnant, so I might have to go on medication.
She also told me very kindly but firmly that I have to prepare myself for this happening again, since there's no known way to prevent pre-e. She wanted to make sure I understood the risks, and while I'm certainly appreciative of the fact that she wasn't "blowing sunshine up my butt" (which I never want someone to do to me ever, ever again), I feel discouraged and afraid. She even said that the hope would be that we would be able to safely manage my symptoms long enough to get me to at least 25 weeks with a future pregnancy so that if I had to deliver early again, the baby would have a chance at survival, and that she'd be thrilled if I got as far as 32 weeks. Yikes!
My primary doctor asked me right away about conceiving again, and both she and my new ob/gyn said it was okay to start trying after 6 months, but the MFM encouraged me to wait at least 9 months. She said that if I have another pregnancy too soon, I might have a really difficult time emotionally and pregnancy is already hard enough. She also said that, because my body experienced so much trauma with the preeclampsia/HELLP and the c-section, I need to give it more time to completely recover. I think she's right, but I feel torn in several different directions. I'll be 40 soon, and it took a while to conceive Molly so it might take a while next time--or I might not be able to conceive again at all. One of my aunties went through early menopause at 41, so that freaks me out. Plus, I've read there is a theory that the risk of having preeclampsia with a future pregnancy is reduced if the pregnancies are closer together.
Aside from that, she recommended that I start on low-dose aspirin before conceiving, as well as higher doses of calcium (which she said is okay as long as I'm not prone to kidney stones). I asked her about the supplement L-arginine and she hadn't heard of it, but said that she is open to trying things as long as it won't cause harm to either mom or baby. I also asked her about high doses of folic acid and she said she didn't see harm in that--since it's a water-soluble vitamin, my body would just pee out what it didn't need. When I mentioned the use of heparin, she was very skeptical due to the risks involved.
All in all, I did really like the MFM and it seemed like she would (at the request of my OB), monitor a future pregnancy extremely closely. But basically, she said that's all they can really do.
I'm still trying to process everything. It's a bit overwhelming. Any thoughts?
Mommy to Molly, who was born alive on Oct. 29, 2011 at 23+3 weeks due to severe pre-eclampsia/HELLP syndrome and passed away 3 hours later. Loved and missed every minute of every day...."If love could have saved you, you would have lived forever."