Trigger warning: mention of miscarriage

recovering from endometriosis surgery — Recovering from endometriosis excision surgery.

The road to get here was not easy. I got pregnant in the fall of 2019, followed by a miscarriage (my 4th), endometriosis diagnosis, then endometriosis excision surgery in 2020, in the middle of a pandemic. I was sure I'd get pregnant after surgery but instead I dealt with a long recovery, more pain, and another year of trying for a third child.

Meanwhile it seemed like everyone around me was easily conceiving and joyfully announcing their pregnancies. Side note: if you're in this boat now, it's ok to feel sad when you see announcements. It doesn't make you a bad friend. It makes you human. If you have a loved one experiencing loss, I wrote a post here about how to support them, which you can find here.

I finally made an appointment with a fertility specialist, but had to wait several months to be seen. In retrospect, I wish I did this sooner, but I was naive in thinking the endometriosis excision surgery would be my magical cure. We had our first fertility appointment and then my husband was evaluated. My bloodwork was scheduled for my next period, which never came.

Family of four in front of Golden Gate bridge. — The day after my positive test, we flew to San Francisco for my cousins wedding.

In September 2021, I got my long awaited positive pregnancy test. I didn't get my hopes up. I have been pregnant 7 times now, and only have two children. I was shocked at my first appointment when my doctor found a heartbeat. After that, due to my history of recurrent loss, I was at my OB or maternal fetal medicine (MFM) doctor every other week. Every time I went to the bathroom, I checked for blood. I didn’t take any bump photos. Before each appointment, especially those first few weeks, I mentally prepared myself for the worst. For me, that was easier than hoping for the best and being disappointed.

At my first OB appointment, my doctor warned me this pregnancy would be tougher than the others because I am older. At 37 years old, I am considered a geriatric pregnancy, a term I genuinely loathe. I knew being pregnant wouldn't be easy as it never has been for me. Now I am older and my body isn’t as forgiving as before. Encouragingly, both physicians told me endometriosis does not increase my risk of miscarriage. However my history of recurrent loss does increase my risk of miscarriage.

This pregnancy started off with way more nausea and extreme exhaustion than I’d experienced before. The first trimester I napped like I've never napped before. I'm talking, I couldn’t keep my eyes open to save my life. Some days I napped the entire time my daughter was at preschool. I felt guilty for not spending my time working but my body didn't' give me much of a choice. I experienced cramping the first several weeks — also worse than previous pregnancies, most likely from endometriosis. The cramping slowly got better.

10 weeks pregnant at the beach. Trying to keep it together for the kids while feeling like I needed to puke all day.

At each appointment, I was pleasantly surprised when we heard a heartbeat. I still didn't get my hopes up as I know things can go wrong at anytime. Then around 10 weeks I had to go to the ER for dehydration from a stomach bug. At the ER I was diagnosed with a subchorionic hematoma. A hematoma is bleeding that occurs between the placenta and uterine wall. The causes of hematomas are not clear.

I had been trying to stay off Google this pregnancy because in previously pregnancies I spent way too many hours analyzing all the things that could go wrong... and there are a lot. It was always really hard not to google every symptom and find the worst possible outcome. Then I'd spend hours on mom support pages, most of which were filled with mothers experiencing issues. This time around I was too busy to do this and realized it provided no benefit to my mental health. I was also less worried about all those strange symptoms... until now. I never experienced a hematoma before and I always want to learn as much as I can so I can advocate for myself. Dr. Google was not reassuring on the hematoma front and I prepared for the worst.

Then I saw my amazing MFM doctor who said my hematoma was small and assured me I didn't need to be worried. Small hematomas are common, tyipcally not a cause for concern and usually resolve on their own. He warned me I might have spotting, but to call with any concerns. I hadn't had any bleeding so this appointment made me feel much better.

At 12 weeks I had my more in depth NIPT scan. This was a big milestone for me as we found a fatal abnormality during this scan in a previous pregnancy. I was so anxious sitting in the waiting room and during the entire ultrasound. I analyzed every face the sonographer made. Was that bad? Did she find something she can't tell me about? The scan went well and I got to see our little baby moving around on the screen! Babe looks like a real human now! I am so relieved and starting to feel cautiously optimistic.

Well a few weeks later I started bleeding and cramping. Not light spotting, but heavily bleeding with bad cramps. And I am no stranger to cramps. I was sure I was miscarrying again as the feeling felt very similar. I called my OB who couldn't see me right away, but luckily my MFM had me come in for an ultrasound that hour.

This is where I spent the week taking it easy.

Much to my surprise, my baby was totally fine. The hematoma had not grown. Heavy bleeding and cramping can be normal with a hematoma. The doctor warned me the bleeding might stop and then start again. They told me I could still come in whenever I was nervous.

I was told to take it easy while I was actively bleeding, but that best rest has NOT been proven to positively effect hematomas. I took it easy that next week but those days were so unnerving, even with my doctor's reassurance. I was already constantly worried something would go wrong. Now the main symptom of something going wrong was present daily. Talk about major anxiety.

Mama and Lincoln @ 12 weeks pregnant — Enjoying holiday fun around 12 weeks. Definitely a good distraction!

I wish I could have a more positive outlook. I wish I wasn't so worried all the time. I wish I wasn’t afraid to take milestone photos. But the truth is, this is what pregnancy after loss looks like for me. It's ok to be cautiously optimistic or not optimistic at all. It's ok if early pregnancy isn't filled with hearts and rainbows. We can still be grateful for being pregnant while feeling these emotions. I am so grateful the first trimester is over and I still have a healthy baby.

I'll share more about the second trimester soon! If there is anything specific you want to know about, leave it in the comments.