God Bless the Sheep Clock

We went through a really rough period with sleep recently. Once Ethan graduated to the toddler bed last summer, he began wandering into our room at night. Mostly he would go back to sleep promptly, but sometimes he would be sad, mad, dramatic. That made us sad, mad and dramatic. Othertimes he would be all happy guy, ready to play. I do not like to play at 3 AM.

After our sweet winter vacation in Madison, when we all slept in the same room again, Ethan's nighttime wakings became unstoppable. How could he ever consider sleeping through the night on his own when he had these warm-bodied friends so close by?

He started waking up many times a night (4? 5?) sometimes up for hours either crying or playing or being mean or resting peacefully only if we were in physical contact with him. Jeremy and I got really tired. We tried yelling and time outs but those were totally ineffective and left us all bitter. We tried playing it cool, no drama, but that felt false (we were not cool with being up all the freakin' time).

Then we found the sheep clock. A neighborhood mom told me about a stop-light clock she got for her kiddo to help him stay in bed for nap time (even if he wasn't sleeping). We got a similar clock that has a sleeping sheep illuminated at night and an awake sheep that lights up at a pre-set time (we started with 5 AM and have worked it back to 5:30). Ethan understood immediately that he was supposed to stay in his own room until the sheep woke up. But he did not immediately obey the sheep. So, whenever he came into our room before the sheep awoke, we would walk him back to his room and trap him inside with the baby gate, which we didn't remove until the sheep woke up. That really sucked. He cried and screamed for hours. I felt like I was cruel and unloving, like I was torturing my little guy, who only wants to be close to us. But I know Ethan's tendency to push and push and push all boundaries until he encounters some firm consiquence. He loves to make us angry. He does not love being denied our attention while stuck in his room in the middle of the night. Perfect motivation to sleep through the night, right?

In spite of the screaming (which even earplugs could not obscure), we vowed to keep up the routine for a month. (Don't tell Ethan, but if the sheep clock failed we were going to set up a little bed for him in our room.)

After a couple of weeks, he just stopped coming into our room. It's been almost two weeks since he's come in before the sheep says it's okay. Sometimes he sleeps 45 minutes later than the sheep! He won't go to bed without it and he sleeps with the clock inches away from his face. He comes in every morning silently, holding the sheep clock up proudly, a huge grin on his face. God bless the sheep clock.

Trying again

I found this passage very helpful in thinking about getting pregnant again after a miscarriage. I copied and lightly edited the text from a religious site that I do not otherwise recommend.

Many sites and many providers give oodles of false information. There is no evidence to support waiting three months. There are some good reasons (listed here) for waiting at least one cycle.

Accept that there are many opinions.

Doctors are trained to recognize that a woman needs emotional healing, but not really to help them or explain it to them, since it goes beyond their "bones and tissues" type of practice. Three months is considered the average amount of time a woman will grieve hard over a loss, and will have a difficult time if she gets pregnant prior to that. While there are a few doctors who believe that your uterine lining must take three cycles to get back to rebuilding itself fully each time (especially after a D&C, where it gets scraped pretty thin), most doctors know that it doesn't really matter, and getting pregnant again right away does not carry any increased physical risk or miscarriage risk.

So even among doctors, some will say the standard "wait three cycles" and might even scare you into thinking you'll have another miscarriage if you don't wait, and others will say go ahead and try again now.

As for my opinion (and have talked to thousands of women who have had miscarriages) you really should wait for one cycle to complete, because if you do not, you will experience one of two situations, both of which will cause you much unnecessary grief and pain:

1. If you do get pregnant again before having a period, you will not establish a reliable Last Menstrual Period date (your miscarriage date is of no use). You will run into problems when you go in for your first prenatal sonograms and blood tests, causing you grief (often for nothing) and can wreck your relationship with your doctor (supporting the "difficult patient" theory.)

For example, the blood test will say you are six weeks; you will insist you are eight. The sonogram will not show a fetal pole yet, but you have read that you should see a baby by now. You will think your doctor should do something, but he or she will just say your date is wrong and come back in a week. You will spend a week of torture, wondering if the baby is dead, and why do you have to wait for answers. All these things can be avoided by knowing your LMP, or preferably ovulation. Most of the time, the babies are fine, but sometimes you are having another miscarriage. Everything is murky because you don't know for sure when you got pregnant, because you didn't complete a full cycle.

2. If you have retained tissue, your period will be "late" (although all post-miscarriage periods take more than four weeks and are late) and you can even have a POSITIVE PREGNANCY TEST, but you are not pregnant. This is hCG left in your system from the miscarriage, which has not completed. You may begin bleeding and cramping and think you are having another miscarriage, but you are just still going through the first one. We have had women on the site grieving over a 2nd lost baby, naming it and everything, when it turned out she only had missed tissue from the previous loss. Having a D&C does not guarantee that all the tissue was taken. If you did not wait for a real period, you will not know if a pregnancy test really means you are pregnant again, or if your loss has become a long drawn-out ordeal.

Additionally, charting and even ovulation predictor kits are not reliable tools during that first cycle after a miscarriage, and the body will put out lots of signs of fertility or lack of it as it tries to adjust itself. Women may be absolutely sure of their pregnancy's gestational age, and still be wrong.

On the other extreme, not getting pregnant that first cycle, or for the next few, when you are fervently trying, will actually push your grief further down the line, month by month, and it can really be detrimental to healing, your life, and your relationship. Often your life will completely revolve around trying again and you will feel even more a failure, more unable to cope. This may also happen if you wait, but is more likely to pull you into a clinical depression if you are not yet dealing with your loss and are still having some hormonal upheaval.

Even if you feel like you are fine, the grief is really out there, and you need to work directly through it.

In the end, this is your life and your body, your baby, your future, and your decision.

These concerns do not dissuade me from trying again right away, as both of my pregnancies have had an unhelpful LMP, I've already had a negative pregnancy test since my miscarriage and I do not feel full of unresolved grief. However, the issues raised here are worth thinking over. They are certainly so much closer to the heart of the matter - which is that the primary healing and readying to be done before, and even after, getting pregnant again is emotional.

What it means to be pregnant

I had a miscarriage this winter. The embryo, if there ever was one to speak of, didn't develop past 7 weeks. I found out at 14 weeks and passed the pregnancy at 15 weeks. That was three and a half weeks ago.

I have seen enough pregnancy losses in my time at the birth center, amongst family and friends, and thus far in medical school, that I always keep myself open to the notion that a pregnancy may not work out. When I found out I was pregnant in November, I was not anxious or pessimistic, just realistic about the possibility of loss. I felt sick and crabby and tender - all normal pregnancy symptoms, all reassuring. Somewhere around 9 weeks the symptoms fell off, but that was not too unusual and didn't alarm me. We never heard a heart beat.

In spite of my awareness of pregnancy loss, I was nevertheless surprised and saddened and disoriented to see on the ultrasound that my growing uterus was nothing but an empty sac, a dark vessel full of fluid and a little cellular detritus but no baby. The map of our lives was suddenly redrawn. The vision of a healthy summer baby that I had been cultivating felt like a sham. My interpretation of my changing body had been all wrong - I wasn't pregnant and I wasn't having a baby. I had been tricked.

I was weepy and kept thinking about how foolish I had been, thinking I was pregnant all this time. How could I have read so much into the nausea, the fatigue? How could I have been so utterly mistaken about how my year would unfold?

As I passed the pregnancy a week later, with the help of a little misoprostol and a very kind friend to support me, I found the experience more interesting than sad. It was kind of like labor, but only the beginning of labor, in the same way that I'd only had the beginning of a pregnancy. I was relieved that my bodily experiences finally matched my understanding and expectations. I felt kind of lucky to get to learn about pregnancy and miscarriage in such an intimate way.

What I gave birth to was definitely not a baby, and there was none of the ecstasy or agony or high drama of a live birth. But I saw that Jeremy and I had created something. Some unique biologic event had transpired and I had gestated our conception these weeks and now the pregnancy was done. I no longer felt that I had been tricked into thinking I was pregnant. I realized that I had just been wrong about what it means to be pregnant. My view was too narrow. Most of the time one sperm meets one egg and a healthy, beautiful baby is created. But pregnancy can be something else - the genes can be all wrong and no embryo develops, or it starts and then stops growing, or the pregnant woman decides to terminate, or there is a normal fetus that dies spontaneously. Sometimes really freaky things develop, like hydatidiform moles or cancers. Miscarriages (and blighted ovum and abortions and all the others) are pregnancies too, just so far from what I hoped and expected for myself that I hadn't really consider them comparable to the normal gestation I'd had with Ethan. But really they are all on a continuum, and I just happened to have one of the other varieties.

This miscarriage is teaching me that pregnancy doesn't mean baby. It means something new and and unique has been created inside a womb. This type of creation inherently brings intense physical and emotional experiences for the mother. Whether it ends in an epic push or a quiet trickle of blood or a noisy vacuum aspiration or in surgery, this new something inside our bodies comes out. And the emotions may be so many things and so many things at once - loss and joy and fear and pain and annoyance and regret. But the hormones of pregnancy (whether in normal proportions or wildly abnormal) and the reality of some new biology following it's own life trajectory inside of us stirs the heart. Pregnancy starts with gametes and takes a woman on an journey, of flesh and of feelings, whatever the outcome.

Perhaps this is obvious, but somehow feels like a new truth to me. To see how my no-baby pregnancy is the same as the pregnancy that brought me beautiful Ethan in these fundamental ways helps me to understand and appreciate this chapter in my reproductive history more completely. It's sad and unexpected but awesome and beautiful too.

This miscarriage has also helped me to realize that if Ethan is the only child we ever have, I have been deeply blessed. I do expect to have more babies, and hopefully soon, but I know now that anyone else that joins our family is a bonus. We have already had such a gift in the utter love, the joy, the fun, the closeness, the insufferable whiny-ness, the late nights, the rage, the challenge of parenting. We are so lucky.

Inside

Here are some of the ways we've played inside this winter:

Dressing up in Daddy's rugby jersey.

Legos

Trucks, Loaders, Backhoes

Art

Music

Stuffing things into snowtires and lying on top.

Cooking

Feeding Nana's dog

Tools
(This file is only an emblem of the many tools that Jeremy and Ethan use. Ethan lives for the moment when the toolbox comes open.)

Run Jump

How Ethan unwinds before bed every night.

Ethan the Photographer

Great Bear Cabin

Jeremy and I took our first ever overnight away from Ethan last week, in the short 3-day break between semesters for me. Nana and Ethan had a slumber party while Jeremy and I camped out in a rustic cabin owned by the Dartmouth Outing Club. I remember hearing about cabins and woods owned by Dartmouth during my medical school interview and thinking that I would love to explore these outdoorsy gems - but medical school and toddlerhood have taken up my time and then hasn't been much roughing it lately. Until now!

After a most tearful goodbye with Ethan at daycare (he clearly understood that we were going away and this was something very different than usual), we drove about an hour to a little trailhead along the Appalachian Trail at the base of Mount Moosilauke. We snowshoed to Great Bear Cabin, dropped our stuff, ditched the snowshoes because the trail was so well packed and hiked the mountain in the most incredible 50 degree February weather I could have wished for. Clear skies, snow covered trees, steep ascents, quiet. It was lovely.

We slid a fair amount of the way back down on our haunches, for fun and speed (how we wished for sleds!), got back to the cabin at dusk, built a fire, read books, chowed down a dinner that we cooked on the wood-stove, and relished the chance to go to bed whenever we wanted, with no kiddo to worry about. This freedom inspired us to stay up to the late hour of 9 PM! The cumulative fatigue of school and parenting and climbing a mountain clearly caught up with us.

The next morning we lazed, played scrabble, read, ate, and drove home to find a perfectly happy two year old napping peacefully. Happy Valentine's Day to us!