This has been a long process. Over a year has been devoted to the surrogacy process, while the initial conversation started around three years ago. And here we all are, in the after of a life-changing experience.
Karen and Chad have been struggling to start their family for nearly a decade. They've experienced obstacle after obstacle, negative outcome after more bad news. Karen has endured so much testing and medication and experimental treatments and multiple rounds of painful egg removal. She did have one successful transfer, but it ended up ectopic and had to be terminated, which was absolutely devastating.
Meanwhile, I fall pregnant easily and have four healthy, active children. So why not offer? It's one thing I could do.
In October 2023, Jake and I took an overnight trip to Waltham MA where Boston IVF is located. We had a nice date night dinner at a Mexican restaurant with tasty margaritas.
The next day, we both underwent a battery of tests: blood work, physical profile, mental and emotional health screening, counseling with the nurses, learning about the medication process and what would be expected. We were ready to get this process moving forward!
Then we had to complete a meeting with a social worker, both individually and then as all four of us. She flagged me for anxiety, which was not a surprise for any of us. Then lawyers got involved drawing up a surrogacy agreement per the new NY laws. It seemed to drag things on forever, especially as we had talked about the whole process and had agreed on the major items long before! At some points, Jake and I were frustrated with the legal hoops, feeling that the lawyer was trying to add in restrictions and further protections we felt were unnecessary.
I started birth control in December 2023 or early January 2024, to help regulate my cycle and plan for optimal transfer. I had to ask for an adjusted lower dose because the amount of hormones were too much for me to handle.
February 2024 we started the preparation cycle, with check ins for blood work and ultrasounds beginning in early March. Karen & I traveled out to Waltham again on 19 March for the transfer.
I remember lying on the exam table watching the ultrasound on the video monitor as the doctor transferred the embryo. A tiny white dot moved out of the catheter, a small spark floating away into the uterus. We drove back home and I prayed that this embryo would stick, that the pregnancy would progress, and be healthy.
We continued with the medication regimen and on 29 March, I returned to the Albany IVF clinic for blood work to test for bHCG. Karen texted that she was going to be a wreck either way, and could I please call her after the office sent the results? I took at an-home test that morning and the office called with my results in the afternoon. I called Karen and said "Do you want the good news, or the better news?"
We were pregnant. (!!!)
Karen and I went for dating ultrasounds on both the 18 and 25 of April, which measured the baby growing right on track and confirming a due date of 05 December 2024.
Somewhere around 6 weeks, I was given the go-ahead to change the medication process and switch from progesterone shots every day to every third day, which was incredibly helpful. I definitely cried with relief. The extra high levels of hormones to help the pregnancy progress were making me more ill with first trimester nausea and food aversions than in any other pregnancy I'd had. I was so, so tired and afternoon naps were required every day. At 10 weeks, we got the news that I could stop with the extra medications, that the pregnancy was doing exactly what it needed to and I was officially "graduated" from the IVF clinic.
"The Great Pumpkin" for Halloween
Homecoming dance
Now it was a waiting game for the next 30 weeks to grow and deliver a healthy baby. Every week, Karen would make me a different "baby cake", sometimes themed with different flavors depending on how big the baby was at that time. There was a pumpkin-flavored cake at 37 weeks, a watermelon low-carb cake in the summer, a carrot cake at some point.
At Desiree's baby shower, 37 weeks
The pregnancy was difficult; more difficult than I remembered for my kids. The symptoms seemed to develop earlier and be more intense. So, while I remembered having back pain or finding it hard to walk in other pregnancies, this one seemed to develop those difficulties about 2 weeks sooner than I had remembered.
As November ticked by, we were waiting but also trying to avoid certain dates-- Karen very much wanted to get through Thanksgiving; Chad wanted to have the bathroom renovation finished, the insulation all installed, and the new HVAC/air handler ready to go. They worried about there being only subfloors in the upper level of the house. I wanted to get through the semester; Jake had in mind his busy holiday concert season. We kept talking about "threading the needle"-- getting through certain events but hopefully having the baby arrive between or before other events.
At the 39 week appointment (Nov 29), I asked Heidi our midwife to please do a membrane sweep to see if that could get things moving along. She reported that the cervix was "mushy" on the exterior and was able to, with baby's help, "mess around" to hopefully get things moving. It did work-- I started having mild but noticeable contractions that evening and all throughout the next day. They never really picked up steam or developed into a pattern, so by Saturday evening I took a bath and had a half glass of wine to help things calm down and to get some good rest.
Sunday (Dec 1) was quiet. Jake and Ben had an afternoon event which he was happy to be able to cross off his list. Later that evening, contractions started picking up again and continued sporadically throughout the evening and into Monday. We really thought at any moment things would find a rhythm and we'd be working through everything very quickly. Jake took Monday off from work and we stayed at home resting but monitoring. We phoned everyone to put them on alert, but again things didn't seem to ever settle into a pattern and the contractions never got more intense or closer together (every 15-20 min, still very mild). Things quieted down overnight, and Jake decided to go to school on Tuesday (Dec 3) while he still could, as it was getting close to his holiday concerts.
Everything was quiet Tuesday; Heidi decided to stop by to check on us in the evening and everyone came down for dinner. While we were eating, the intensity of the contractions definitely picked up and there were several while Heidi was there monitoring during dinner. This seemed to really be "the sign" that things were happening. She checked my dilation before leaving, and I had made some progress (maybe up to 3 cm?). She told us that she'd have her phone with her all night, and expected that we'd be calling in the midnight hours.
Contractions definitely picked up once the kids had all gone to bed. I worked through them every 5-10 min overnight; they were sharp and burning and most of the pain seemed to wrap from hip to hip in my back in a line. I could manage them by breathing and swaying. I was using a hot pack throughout and would crab walk up and down the stairs sporadically to re-heat in the microwave. The Christmas tree lights were glowing softly, and it was peaceful. I kept telling the baby "Let's do this. You and me. We're going to do this together."
By morning (Dec 4), I was working hard through the contractions, and it was up to Jake to get the kids ready and out the door for school. The big boys stayed behind to put the littles on the bus, then walked up to the high school and were tardy that morning. Heidi, Karen, and Chad arrived sometime before all the kids were gone. I remember looking at the clock sporadically, thinking "This baby needs to come out in the next couple hours. The kids only have a half day at school and I need to be done by the time they get home."
We did all sorts of positioning techniques- Rebozo, hands-and-knees, on the yoga ball, in the tub. I thought I was making good progress and everyone else seemed to think so as well; Heidi was getting all the materials assembled for when baby arrived. I kept having repeated episodes of adrenaline-fueled shaking interspersed with the contractions, which was very odd. I had never had that shaking before during labor-- it usually came afterward.
I got into the pool, which was warm and lovely and really helped with the back pain. I could feel baby trying to move lower in my pelvis and worked with those sensations, trying to get things to move more quickly.
Chad was kept busy making hot water to refill the tub. Karen and Jake offered me honey and orange Gatorade and later, lime LMNT electrolytes, to drink. Everything tasted terrible but I kept sipping and working through contractions. Heidi assessed my dilation (only 4 cm) and encouraged me to get out of the tub for a while. We did more positioning techniques; at one point Heidi tried to re-align baby's head from the inside during a contraction. Baby was trying to descend with their head tilted slightly to one side, so even though the contractions were strong and regular, dilation wasn't progressing smoothly. Jake told me later that Heidi and Rose assessed me at 7 cm, had me work for an hour on the toilet, walking stairs, all kinds of different positions, only to still be at 7 cm! I'm glad I didn't hear any of these numbers throughout, because it would have really discouraged me.
The littles came home on their half day at 11:30, I don't know who settled them in. My parents drove in around 12:30 to collect the littles and take them to the farm. Pepper was confined to the basement to stay out of everyone's way.
At some point mid-day, I said that I couldn't do it any longer and Heidi sent me and Jake to sleep. I think she sent Karen and Chad home, Jake fed the midwives some lunch and they also napped. I tried to relax in the bed, lying on my side with some Benadryl on board to help me sleep. Contractions spaced out a bit, which was very helpful, but they were still very painful and still sharp and burning in my back. I was worried I wouldn't have strength to push the baby out as this stage was taking so long and using so much of my energy.
After some time, I woke up and we continued to work on positioning. I was at a 9 cm, with an anterior lip, but when the contractions moved toward more of a pushing-type, the cervix was descending with the baby. Heidi tried to hold the cervix back while I pushed past it, but we were unsuccessful. I labored on the toilet, Rose suggested some positioning techniques and poses to try and baby's head was still just not aligned perfectly.
Around 6 pm, I gave up. I said "I have to go. I can't do this anymore. I don't have the strength to get it out." and we made plans for hospital transfer. Jake was surprised-- I had been so adamant in all my other pregnancies and labors that I would NOT transfer, ever, that he didn't really believe that I wanted it. He thought it was a sign that we were close to delivering and kept encouraging me that I could do it. But we packed everything up and got into the car to transfer to Burdett Birth Center in Troy.
Labor in the car was HARD. I was already tired from a whole day of active contractions and any slight bump in the road triggered another one. Jake drove us to Troy as quickly as possible, contractions coming about every 5 min. Once we got to the hospital, Rose parked the van for us while Jake and Heidi helped me to the Birth Center. I could not walk without triggering another contraction, so Jake stole a wheelchair from the front desk to help move us along.
We were ushered right into a delivery room and met our primary nurse, Abba, whom Heidi had known as a child. She was absolutely wonderful. They got me all hooked up to monitors and an IV and started an infusion of Ringer's lactate. I ended up getting 3 liters of fluid, which made for some interesting swelling and edema in the immediate postpartum period! The anesthesiologist was off-site, so we waited for the fluids to run while she was en route.
The OB came in and examined me, confirming Heidi's assessment of 9 cm with an anterior lip. We tried again pushing past the lip, but the cervix descended with baby again, so we stopped. His assessment was to try the epidural to allow me to relax and dilate fully, then we'd go ahead with pushing again once things were complete.
When the anesthesiologist arrived, everyone had to clear the room except for Abba, who talked me through the epidural placement and held my hands. I had a strong contraction while the anesthesiologist was setting up and asking me questions; it was hard to respond. Then I had a milder one while she was placing the epidural, thankfully I was able to hold still.
The epidural was not immediate relief, but it was pretty fast-acting. Very shortly afterward, the painful line where contractions were centered became less noticeable-- I could still feel the contraction and the pressure involved, but the sharp, stinging, burning pain had faded. I had to lie flat on my back for 10 minutes to allow the medication to circulate around my lower spine, then Abba helped me to maneuver onto my left side with my leg up on a peanut ball to encourage my hips to remain open. I received some more Benadryl and some Pitocin via IV and napped or was semi-conscious for a long time. I heard the others having dinner in a corner of the room, Heidi stepped out to another space to rest, and I just drifted. (Jake remembers it was about 10 pm after the epidural was placed and I was resting while they chatted and ate.)
Every 30 min or so, Abba would come and reposition me to the other side to keep the epidural flowing evenly. I could feel baby finally descending through my tailbone but it wasn't painful (that part of the pushing phase has always been one of the hardest for me, because it hurts so much for the vertebrae to move out of the way as baby's head descends).
Finally, around midnight, I woke up fully and felt that I had enough strength to get things moving again. Apparently, the baby monitor had been recording slight decelerations in the heart rate, which indicated the baby's head was moving down into the pelvis and was ready to come out. (Jake tells me that they had been conferencing in the hallway and watching baby's vitals for a while and decided it was time to get things finished). We wrangled my very floppy body onto my back again and Jake helped hold one leg while a nurse and I held my other thigh (I did not like how the numbed skin felt, all my sensations were "off" and my skin felt almost plasticky under my hands).
Heidi checked me and the baby's head was about 1 inch from crowning. The lights came on in the room, suddenly there were many more bodies (I think I saw briefly about 4 nurses and the OB standing back from the bed). Heidi and Abba coached me in pushing. It didn't hurt, but neither did I have enough sensation to feel where things were happening or if I was pushing correctly. I ended up relying on Heidi and the nurses' verbal commentary to help me know when I was doing well and when I needed to change things up. Jake said later the actual pushing phase was about 15 min (my fastest yet!). I didn't feel the "ring of fire" or any extra pressure during crowning, but Heidi announced what was happening. I did feel a slight 'pop' when baby's head came out, breathed hard a couple times and pushed again. Heidi told me the posterior shoulder was coming, then one more big push and baby was out! It was 12:37 am on the due date of 05 December 2024.
Baby was wrapped up in a blanket by Heidi and passed up to lie on the bed next to me, where Karen was able to scoop it up and hold it against her chest. Baby was crying, we were all crying. I kept saying "It's a baby! Karen, it's a baby!" Karen unwrapped the blanket and we learned it was a GIRL !!! When the cord was done pulsing, Chad cut it free and the little family moved over to the couch in the room with a nurse to hold baby and encourage her to latch, which she did immediately and voraciously.
Heidi stayed on the end of the bed with me, feeling for the placenta to come away. She did some mild traction and fundal pressure and I tried to push it out, but was still so numbed that I couldn't really feel anything. After some time, the OB stepped in and he ended up having to do a complete manual extraction of the placenta. The epidural had been turned off, but I was still mostly numb so only felt pressure but no pain during the whole process. Pitocin was running through the IV continuously, which helped with keeping everything contracting and preventing too much blood loss. Still, there was a lot of blood on the OB's paper gown that he took off after the procedure, on the pads the nurses quickly wrapped up and threw away, on Jake's pants where it had sprayed during the process...
In the aftermath, Heidi said, "We could probably have done a manual extraction at home, but I would have been shitting bricks the whole time and we probably would have ended up transferring anyway. So many times, we think we are heading to hospital for one reason (baby's head not aligned and not dilating) only to find out we really needed to be there for another reason (retained placenta and potential postpartum hemorrhage)."
Karen, Chad, and baby Girl were moved to another room with some nurses to help them adjust to this new life. Jake climbed into the bed with me, I had a little snack (graham crackers and apple juice; finally something that tasted good!) and we napped while waiting for the epidural to wear off. After a couple hours (around 3 am), I had enough sensation to go to the bathroom and we moved into a smaller postpartum room for another few hours of sleep.
I was awake around 6 am, got myself back to the bathroom on my own power. Jake woke up, we got dressed in whatever we had thrown into a duffel the night before, and stopped by Karen & Chad's room to say good morning and officially meet our new niece! They stayed in hospital for another full day, learning all about their new baby, nursing, diapers, and all the fun stuff that goes along with being parents.
For Jake and I--We really wanted to get home to our own babies! We did not make it in time to see the bigs onto the bus (we called them instead) but we did get home before the littles left for school. Then we spent the rest of the day napping and eating, recovering from the long labor process.
So thankful for this experience and for helping my sister become a mother! Baby girl is absolutely perfect.
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