Thoughts on Pregnancy Loss, Two Years Later

NB: Today I’m going to be talking about my past pregnancy loss. I am also going to be talking about my subsequent pregnancy and living child. So if either of those are topics that you’d rather not hear about, please enjoy this picture of my cat and come back next week for more tea and frivolity.

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For those who don’t know, October is Pregnancy and Infant Loss Awareness Month. It also happens to be the month in which I personally became aware of the reality of pregnancy loss. I shared my original feelings in a post here.

Two years ago today, I went for what I thought would be my first look at our new baby. And then I learned how it feels when things go not at all the way you’d expected or hoped. It wasn’t a dramatic moment, but I will never forget sitting on that table, looking at the ultrasound monitor with my husband and the technician and hearing her say, “It’s a little… small.” She quickly walked it back and said we would see the doctor to discuss it. I’d spent enough time on pregnancy subreddits to know what my eight-week ultrasound should have looked like, so I sat for the half an hour that it took for the doctor to be ready and tried not to cry. I failed.

It felt like hours that we spent in the room with the doctor as she explained why she thought I’d had what is called a missed miscarriage, comforted us, and talked us through what came next. It turned into an almost-month-long process of trying different methods to pass the pregnancy, but that first moment of connection was, oddly enough, what cemented for me that I wanted to stay with this doctor’s office when I eventually got pregnant again.

That was the day I joined a club of really awesome people who have a really crappy thing in common.

I am not a naturally sunny or optimistic person. But I consider my miscarriage to have the silver lining of helping me not only realize how supportive my doctors were, but also to help me connect on a different level with so many people I already knew. Even at the lowest point in those first months, I had people I could turn to, and I was so so thankful. If you reached out to me or if I talked to you about my loss in those months, know that I appreciated it more than I ever expressed, even though I unevenly disappeared a lot back then. It hasn’t taken much to see the bright side of the situation.

Last year, my first pregnancy’s due date passed without remark because I was already pregnant and simply too ill with first trimester nausea to notice what day it was. A year ago, I was in my third trimester and on the edge of my seat, simultaneously excited and scared. The problem about pregnancy loss is that it’s not just about the pregnancy you lost. It is a stark reminder that, despite the reassuring statistics, you can lose your baby at any time. It’s a tough thing to deal with mentally when you just want to be excited, buy some cute baby clothes, and pee for the twentieth time in half a day. In a way, I was holding my breath the entire time I was pregnant with Elliot.

I felt myself release that breath the moment I heard Elliot cry in the operating room and the doctor pulled down the sheet for a moment to introduce me to my baby.

I would love to say that it all got better once my baby was born, but I’ve shared experiences on my pregnancy blog that would make you know that’s a lie. I will say that I have enjoyed every minute of being with this remarkable little being who made it through, even when I absolutely hated it. But it doesn’t erase my loss. And, somehow, seeing Elliot grow up has made me think more about the baby he wasn’t.

When Dan and I were talking about having babies, we would often talk about names. We had a lot of girls’ names we liked, and couldn’t agree on a boy’s name. I not-so-secretly hoped I had a girl. When I got pregnant for the first time, I wouldn’t have admitted it out loud, but I was sure I was going to have that little girl, and I knew what I wanted to name her.

Seraphina.

I am not a religious person, but that right there is dramatic irony. And when I got pregnant again and we discussed names, I knew that, even if this baby were a girl, I just didn’t want to use that name again. It wasn’t that it was cursed or bad luck or anything. It just… wasn’t the right name again. I also was much less sure that I was going to have a girl (although, I’m not one of those “I always knew” mothers — we had two names picked out, one for a boy and one for a girl).

So today, I’ll be thinking of Seraphina-who-wasn’t, and I’ll give Elliot-who-is a big hug and know that now it’s my turn to welcome new members into that really crappy club full of awesome people and let them know that it doesn’t go away, but it does go forward.

My Fragrance-Free/Low-Scent Skin Care Routine

Those of you who follow my Instagram may have noticed that once again, my skincare routine has decreased in complexity. Since my first trimester sensitivity to smells kicked in, I found that even my lightest-smelling products would sometimes bother me. I had to pare my routine down to simple basics that would provide hydration and nourishment, without aggravating my nose on a regular basis. Seriously, I thought I was sensitive before, since I’m prone to migraines, but it’s nothing compared to pregnancy nose.

So I thought I’d share what has been working for me, along with a bit about fragrance-free vs. scent-free. As usual, I focus my routine on proper cleansing, hydration, and nourishment, without too many frills. Since my scent-sensitivity has started calming down again in recent weeks, I’ve been able to add back in a few fun new products, although I still stick to pretty minimal, soothing products.

Cleansing: 

My superstar duo is the Alkimi Cleansing Melt and Jordan Samuel Matinee Gel Cleanser. I use them for a double-cleanse in the evenings and use the Matinee cleanser alone in the mornings. My scent aversions became so severe at one point that even the light rose scent of my previous go-to, Glossier Milky Jelly, was too much for me. I haven’t touched another water-based cleanser since trying the Matinee and I’m about to use up my first tube of it. Now that I’m less sensitive, I’ll probably switch back to use my last back-up of the Milky Jelly, but after that’s gone, I’m switching to Matinee permanently.

The Alkimi Cleansing Melt was less of a love-at-first-sight situation. It’s a perfect example of how “fragrance-free” does not mean “scent-free.” Some “unscented” products actually contain fragrances to mask the scent of the ingredients themselves. Synthetic ingredients sometimes have what people think are “chemical” or “plasticky” smells, and natural ingredients, of course, have their natural smells unless they’ve been heavily refined. The Alkimi cleansing melt is a perfect example of the latter category. The same natural, unrefined oils that give it its beautiful color also impart a mild, earthy smell. Luckily, I did not find it at all unpleasant. Again, I still have one back-up of my old balm cleanser, Clinique Take the Day Off Balm, but as soon as that’s gone, I’m switching over.

Hydration:

I’ve talked in the past about how much I love the Klairs Supple Preparation Toner, and the mild herbal scent from the essential oils isn’t terrible, but I was excited to hear that they released a totally-unscented version of the toner. Now, this is a great example of the first category of “fragrance-free does not equal scent-free” because the unscented toner is not scentless. It has a mild “chemical” scent from the components of the product. I think it smells a bit like treated water, but very, very mild. Plus, since it’s not a conscious fragrance, the scent fades very quickly during application. And the toner itself is just as hydrating and soothing as the original. I use a few layers of this in the morning to hydrate, and I use it as a toner step between cleansing and hydrating serum in the evenings.

For a hydrating serum, I still use the Jordan Samuel Hydrate serum. Have I mentioned lately how much I love this line? I love that the brand doesn’t put fragrance or essential oils in anything, which is probably why they feature heavily in my routine right now. The serum does have a light, natural scent from the natural aroma of the extracts used, but again, it neither offends my pregnant nose, nor lingers on the skin. And it provides a lovely dose of hydration that’s just a bit more substantial than the toner alone. I generally use two pumps of this after toning at night, but I’ve also been known to apply a pump in the daytime if I’m feeling particularly parched.

Nourishment:

For nourishment, I go for oils and emollients. Again, this category features an entry from Jordan Samuel Skin, plus another old favorite. Nothing in this category is anything but familiar to those who have read my most recent routine post, and followed my Instagram routine posts. My facial oil is the lovely Jordan Samuel Etoile oil and my moisturizer is a nice layer of CeraVe Baby Moisturizing Cream.

The Etoile facial oil is beautiful, not too lightweight but not too heavy. I use it pretty much only at night (although a pump of Hydrate and two drops of Etoile mixed together and patted on after morning cleansing give wonderful glow and I sometimes use that when I need to refresh before going out at night, since everyone expects me to be glowing now) after my other serums but before my final moisturizing step. In a pinch, I can use Matinee, Hydrate, and Etoile with nothing else as a simplified, “I’m too exhausted to do anything before falling into bed” routine. In fact, when I was at the height of first trimester sickness and exhaustion, I actually moved my Hydrate and Etoile upstairs to my bedside table so I could apply them after falling into bed in a bit of a stupor.

That said, my skin has been dry enough that, even in the humidity we’ve had recently, I’ve still been finishing my evening routine with a generous blob (maybe chickpea-sized) of CeraVe Baby Cream. I love this over the original because 1.) it comes in a tube, and 2.) it feels slightly less greasy on the skin. I also use a smaller dab (maybe pea- or lentil-sized) dab of this under my mineral sunscreen in the mornings. It’s soothing, protective, and the ceramides are supposed to be good for my skin. And it is utterly scentless.

Of course, I forgot to include my sunscreen in the photo above, but I’m still using and loving the Make P:rem Blue Ray Sun Cream every day. It’s mineral and gentle and has a very, very light herbal scent and little white cast. I even have it on the word of a darker-skinned friend of mine on Instagram that she also doesn’t notice a white cast, since, at a NC-20, I’m not the best judge of sunscreen residue. A quick wash with Matinee, a few layers of Klairs, a dab of Cerave, and a slather of Prem sunscreen and I can be out the door double-quick, without offending my sensitive skin or my sensitive nose.

So there you have my basic, low-scent routine, which saved my skin while I was too sensitive to use a lot of products. I’m happy that I’ve become a little more tolerant to scent recently, so I can try a few new things, but I’m also glad to have such lovely products available to me so I can survive without the things that bother me. Now, if only I were able to start using my Le Labo perfumes again…

Tea and Caffeine and my Delicate Condition

NB: I am not a medical doctor and am not making any recommendations for your personal caffeine consumption. If you have a health problem, of course, consult your doctor for advice. This is just how I’ve handled my personal caffeine consumption.

As I announced yesterday on my YouTube channel, there’s a reason I’ve been quiet on this blog and on social media: I am pregnant again. Now, I don’t want this to turn into a pregnancy blog — I’ve even created a separate blog for those who want to more closely follow my pregnancy and parenting updates — but I thought I’d talk about a pregnancy-related topic that is near and dear to my heart: how I’ve handled drinking tea while watching my caffeine intake.

Monitoring caffeine is not actually a new thing for me. I have another (minor) health issue that gets exacerbated when I have too much caffeine. But since it’s more uncomfortable than dangerous, I mostly just wing it, assuming I’m taking in less caffeine drinking tea regularly than when I was drinking coffee regularly. When I started trying for a baby, I realized that I should probably figure out how to keep a closer eye on things.

Of course, when you look up “caffeine in tea,” you generally get the information back that an 8-oz. cup of tea has 26 mg of caffeine (or maybe it’s 50 mg, depending on your source). And that green tea and white tea have less caffeine than black tea. But then, sometimes you can find sources claiming that green or white tea have more caffeine than black tea. And few sources mention oolong, but mostly assume it’s somewhere between black and green tea. And finally, most of these sources assume that you make a cup of tea by taking a tea bag and putting it in a mug of hot water for 2-5 minutes.

So what if you don’t make tea like that? What if you re-steep your leaves? What if you use more leaf than they put in the average tea bag? And what is the actual variation among different tea types? Well, it’s unclear. Oh, and to get this out of the way: You cannot “decaffeinate” tea at home by steeping it for thirty seconds and discarding the first steeping. There’s more information about it here, but suffice to say that caffeine is released at a relatively even rate for at least the first 10-20 minutes of steeping, so you’d have to throw away all the enjoyable tea to get “decaffeinated” tea from this method.

The first thing I did was to try to get some information about how tea is handled during pregnancy in countries where tea is consumed more widely than coffee. Generally, in the US, tea is lumped together with coffee and is consumed mostly as a drug, for the caffeine. Caffeine is considered a vice, and therefore something that might be dangerous in pregnancy. In other countries, tea is considered a healthy drink, consumed for its benefits rather than as a vice. I did find a few blog posts  and articles about women’s experiences with recommendations from doctors in Japan, and this video from Mei Leaf, but there’s not a lot of reliable information about how tea-loving countries handle advising pregnant women on drinking tea.

But I do know that the American College of Obstetricians and Gynecologists considered “moderate caffeine intake” below 200 mg per day to not increase risk of miscarriage or preterm birth. Most doctors stick to this number and say that it’s safe to have up to 200 mg of caffeine per day in pregnancy. So, armed with this number, I set out in search of a more accurate way to figure out how much caffeine I was getting from my tea.

From here, I decided I should probably consider how I brew tea. Since I generally tend to weigh my loose tea leaves, rather than using a tea bag, I knew I tended to use 3-6 grams of leaf per session. I’ll sometimes go as high as 8 g if I’m doing a flash-steeped gaiwan session. I also knew that brewing time was a factor, so I looked at the various ways I steep teas. Generally, I like to steep for 30 seconds to maybe a minute or two for each steeping, and I usually do maybe four steepings over the course of a day, so that’s definitely under five minutes of total steeping time. If I look at the white2tea steeping guidelines for a flash-steeping session, those times add up to 275 seconds for ten steepings, or just under five minutes. So I decided I would consider my brewing parameters to be somewhere between 3-5 g of tea steeped for five minutes.

Now, let’s talk about assumptions. I’m definitely making some assumptions here. First of all, I’m assuming that water quantity doesn’t really effect caffeine release. I mean, this may not be the best assumption, but at the very least, brewing more tea in the same amount of water shouldn’t make caffeine release more efficient, right? So at worst, my assumption is leading me to overestimate caffeine. Same with water temperature. The studies I found assume water temperature of 100 C, and I often use cooler water. There are studies of water temperature and caffeine release, though I didn’t look them up specifically for this project, but again, I’m assuming that, again, I’m likely overestimating caffeine by disregarding the effects of water temperature.

Okay, on to the studies. The first one looks at caffeine and theanine in standardized brews of 39 different teas, with the standard brewing method being to steep 1 g of tea in 100 ml of water for three minutes. For my purposes, I multiplied their caffeine numbers by two to account for my longer brewing time and then by 3-5 to account for my increased tea quantity. So if I wanted to steep 5 grams of tea, I assumed I would need to stick to teas with fewer than 20 mg of caffeine, as reported in Table 2. For 3 g of tea, I could go up to teas with about 30 mg of caffeine. Almost every tea in the study would fall under this amount.

I also looked at this post, which got some caffeine information from a couple studies, and expanded the range of tea types I for which I had data. The table in the post considers teas that are brewed with 1 g of tea in 100 ml of water for 30 minutes, which is pretty close to full extraction. So all I did in this case was to multiply the reported number by the amount of tea I would use, which is pretty convenient (and almost certainly exaggerating my caffeine consumption). I especially like this resource for when I want to do a special session with 8 g of a nice pu-erh and want to see just how excessive the caffeine would be.

Now, one more note about caffeine in pregnancy: One of the books I got to prepare for pregnancy was called The Panic-Free Pregnancy, which specifically addresses concerns about caffeine in pregnancy. First of all, the author of that book looks at studies of pregnant women consuming caffeine and concludes that 200 mg per day is too conservative and it’s likely that up to 300 mg per day is probably safe. He also points out that, this is meant to be a limit on average consumption, so if you go nuts and have several espressos one day, you’re probably safe if you limit yourself to decaf the next day (fun fact: decaf coffee has a small amount of caffeine and I personally find that it’s enough to ward off the headaches I get when I have no caffeine at all). So I took this as permission to occasionally indulge in a long tea session, without worrying too much, as long as I was careful for a couple days after that. I particularly like Pique Tea tea crystals for the “careful” days because I can be more certain of how much caffeine I’m getting, and one serving of Pique Tea doesn’t seem to ever have more than 50 mg of caffeine. In addition to all of this, Emily Oster, author of Expecting Better, points out that there doesn’t seem to be the correlation between tea consumption and miscarriage the way that there seems to be a correlation between coffee consumption and miscarriage, which suggests that perhaps there is something else at work here besides caffeine affecting things. Take that as you will.

One last thing: there is another concern with tea in pregnancy. Apparently catechins, which are found in the highest levels in green tea, can bind with folate, which could potentially increase the risk of folate-related birth defects. While this study did conclude that high consumption of green tea did correlate with lower folate levels, this study concluded that, for women who were taking supplemental folate, increased tea consumption was not associated with an increased risk of spina bifida. Personally, I chose to deal with this by making sure to take a prenatal vitamin (which I started months before becoming pregnant anyway) and also to offset my tea consumption and my vitamin consumption. That is, I drink tea in the morning and take my vitamins in the evening. That way, the vitamins and the tea aren’t in my digestive system at the same time.

All in all, you can tell I’ve put a lot of thought into how my tea-drinking could affect my pregnancy. Possibly too much thought (after all, people have been drinking tea for centuries and we’ve managed to keep having babies). But it helped give me peace of mind, and I hope that aggregating some of the information I found helpful might help someone else, too. I’ll close by pointing out that a lot of this research ended up being moot, as my first trimester nausea ended up limiting the amount of tea I drank anyway, mostly because I felt too sick to really enjoy the good stuff.

Where I’ve Been Lately (TW: Miscarriage)

NB: The short answer to the question “Where’ve you been the last month?” is that I’ve been dealing with a miscarriage. So fair warning — that is what I’m going to talk about. I’ll try not to be too graphic, but if you’re not up to hearing about pregnancy, miscarriage, and general health/mental health ickiness, you’ll probably want to just enjoy this adorable picture of my cat and not read any further:

So, hi. It’s been a while since I’ve had a regular posting schedule over here. I got going on my new segment and then stopped updating that, too. I haven’t even been able to put out a beauty or tea review in a while. And the reason for that is that I was pregnant and feeling crappy. And then, well, I wasn’t pregnant anymore, and feeling even crappier.

Miscarriage isn’t really something people talk about in normal, everyday life. Since I found out about my pregnancy and even more after my miscarriage, I’ve found this amazing group of women who have come to me and shared their experiences and that, yes, they know what I’m going through, and that, no, I’m not alone. So if you’re currently going through a miscarriage, you’re really, really not alone. So many people have been there and come out the other side. I’m not sure I’m entirely the best example because, even though I feel like I’m on the upswing, I haven’t even started trying to get pregnant again yet.

Alright, let’s back up to September. Mr. Tweed and I had been trying for a few months, and I was pretty sure this month would be more of the same. Until I got up early, peed on a little white stick, and there it was. Another line. I said something entirely unladylike and called the husband into the bathroom. We were thrilled. I called the doctor and made my appointment for when I would be eight weeks along, and then settled in for an excruciating four week wait. I started feeling occasional nausea around week six, and for some reason I completely lost my taste for tea and developed a wicked craving for coffee. My skin also freaked out and became very dry and sensitive.

Then, we got to the doctor and I got up on the table for the ultrasound tech and she put the transducer on my stomach. We watched as the monitor in front of us started showing images. And then we saw the sac inside my uterus… and not much else. The ultrasound tech made a somewhat disappointed comment, but said we should wait to see what the doctor said. But I knew what it meant. We sat in the waiting room for an excruciating half hour until the doctor was ready to see us. She confirmed the bad news: It didn’t look like much, if anything, was growing in my uterus. We decided to wait a week and come back to double-check. I cried a fair amount that week. After a week, it was more of the same. I got a packet of misoprostol and a prescription for strong pain meds, and went home to miscarry my pregnancy.

My experience with misoprostol was… anti-climactic. I had some cramping and some bleeding and some upset stomach, but nothing even as bad as my period usually is. I was confused and thought about calling the doctor, but opted to wait a couple of weeks. I mean, all my hormonal symptoms had gone away, and I had passed something. I spotted for the entire two weeks. Then, the night before it would be two weeks since taking the pills, I was having some weird cramping, so I put on a pad, just to be safe. Well, it was a good thing because at about 4 a.m., I was hit with a terrible wave of cramping and got up just in time to go to the bathroom before the flow hit. I called the emergency line for my doctor, where I was told to call back if things got worse. Things got worse. They squeezed me in for a same-day ultrasound and exam and the doctor discovered that I had not fully passed the pregnancy and scheduled me for a D&C the next day.

The D&C was almost worse in the hours leading up to it than the actual procedure. I’d never been under anaesthesia before, so I was nervous. But everyone at the surgery center was fantastic and I had no problem going under, or waking back up. I kind of wanted to go back to sleep after they woke me up, but Mr. Tweed was in the recovery room and got me up and talking while the nurse brought me water and ginger ale. After the anaesthesia wore off the next day, I got a bit more sore, but I never had to take any of the prescription pain pills. I was back at work the next Monday (although I had some pain the afternoon and opted to telework the next day), and I made it through Thanksgiving. I had some spotting for the next two weeks, to varying degrees, but almost exactly two weeks after the surgery, the spotting stopped. I had my post-op appointment and the doctor said everything looked fine. Four weeks and a day after my surgery, I got my period again.

And, well, that’s where I am now. At least, that’s what happened. You might notice that I haven’t talked a lot about how I feel about this whole thing. I mean, the short answer is “not great,” but miscarriage is so much more nuanced than that. I’ve been grieving, angry, sad, kind of secretly glad I got to have something to drink at Thanksgiving and Christmas, worried for the future, and absolutely terrified of trying to get pregnant again in case this happens again. It’s a bit of a mixed bag.

And, yeah, it hasn’t helped that the whole process has stretched out for longer than a month. I pretty much didn’t go into the office for about half of November. I’m just now starting to feel like life is getting back to normal. But I haven’t really been up to doing most things that aren’t absolutely necessary. I did get all my gift shopping done, but I’m not really feeling in the holiday spirit. I never put out my Christmas tree (all decorated, but still wrapped up in our storage room). It’s just… really not how I thought this holiday would be this year.

But I’m climbing out, slowly but surely. Exercise has helped a lot, as has giving myself permission to skip things that I don’t feel up to doing. I’ve watched a lot of Netflix when I’m not either exercising or at work. But I read a book earlier this week, which was nice. And I’ve been reading some stories for a new “Tea and a Story” segment, hopefully later this month. And Mr. Tweed and I have gone to a couple new restaurants for our food blog. Like I said, it’s a slow and steady return to normalcy.

I wish I could finish this up with some sort of advice, either for people who are going through this, or people who want to support people who are going through this. But I guess the only thing that I can say is: Be patient. With yourself. With your friend who is grieving. It’s kind of lame advice, but really, every person is different. Some people want to talk about it; others don’t. Some people want to have a ritual or some sort of keepsake. Others really, really don’t. It’s not about specific acts of sympathy or acts of self-care — it’s about listening to yourself and your own needs, or listening to your friend and what they want. I guess that’s really all I can offer.

So that’s really where I am. Hopefully, my regular posting schedule will start back up soon, but it might be a little different. I haven’t been tasting many new teas or trying new beauty products. But I still have life thoughts to share from my quiet little corner of the sofa.