Dillards 90: Degrees, Exams, Vacations and Vaccinations, Oh MY!

[Johannah]

Just weighing in that I agree no matter what it’s progress that miscarriages are finally being recognized and discussed more publicly and there’s no right or wrong way to cope with the loss. 

I have 3 children and have had 2 miscarriages, one between 4 and 5 weeks, and one between 5 and 6 weeks, so both were pretty early. The first one was after I had been trying unsuccessfully to conceive for 7 months, so although it was sad, I also felt like it was reassuring progress to know that I actually COULD get pregnant. 

I also found it comforting to know that the most common cause of miscarriage is a chromosomal abnormality that never would have resulted in a live baby. I didn’t think of it as a person because it was likely an embryo that was incompatible with life. It felt like a potential baby, but one that turned out not to actually be a baby. I kind of had this feeling of oh, that’s sad, I thought this was my baby but I guess it’s not. 

I’m also not religious and never had any thoughts about this being a person I never knew or one I would meet again someday. I know some people find that comforting, but I would not. 

It’s also a reason it felt odd to give it a name, bc it didn’t actually feel like a person. We refer to all of our children while pregnant as a cutesy nickname, sort of like peanut. When we talk about the miscarriages, the first one we called the lost peanut. Once I had a second miscarriage, the first one became lost peanut #1 and the second one, lost peanut #2. 

But I also had very early miscarriages and didn’t require any intervention. I think they would have been harder if I had heard a heartbeat, or if I had lost what I knew to be a chromosomally normal embryo/potential person.

The hardest part for me, because I have struggled to conceive, was wanting a baby and not knowing after each miscarriage whether or not I would be able to conceive again. Once I did conceive again after each miscarriage, I found it incredibly healing and found that it mitigated the loss to some extent.  I would love to try for a 4th, but am a little worried that I might miscarry again and then not be able to conceive afterwards. That would be the hardest scenario to deal with for me, having my final pregnancy end in miscarriage and not be able to have the child I’d been trying for. 

[CarrotCake]

On 10/16/2021 at 6:28 PM, sableduck said:

Almost every pregnant person I know over the last 12 months(so around 10 people, there’s been a baby boom where I work) have gotten the early blood tests that tells them gender.  So before they’re out of the first trimester they’re telling everyone the baby’s name and referring to the baby by name.  
So naming a miscarriage doesn’t seem weird to me.  It seems to be the norm to be finding the gender and publicly naming the baby very early. 

In the Netherlands they are not allowed to give away the sex with the NIPT. Basically, you can know about all their chromosomes except for the X/Y-ones.

It is to avoid people choosing abortion based on the sex of the baby. It's sick that it has to be taken into account but I'm glad they do. After 13 weeks you can still get an abortion of course, but the process is different, it is not as easy anymore.

Edited October 18, 2021 by CarrotCake

[AprilQuilt]

13 hours ago, Johannah said:

I also found it comforting to know that the most common cause of miscarriage is a chromosomal abnormality that never would have resulted in a live baby. I didn’t think of it as a person because it was likely an embryo that was incompatible with life. It felt like a potential baby, but one that turned out not to actually be a baby. I kind of had this feeling of oh, that’s sad, I thought this was my baby but I guess it’s not. 

This, for me. I've had 5 first trimester losses and am under the care of the recurrent miscarriage clinic now who think it's likely that I'm just hyperfertile. Research has shown that a typical uterus lining is not attracted to chromosomally abnormal embryos, so they don't get a chance to implant, but some uteruses are indiscriminate and will 'reach out' to any embryo that comes along. That is to say, most bodies screen for chromosomal abnormality and reject that embryo, so you might never know that your egg was fertilised that month. Mine's just like, yep, come on in, make yourself at home! I get pregnant easily and then miscarry quickly. Not that this isn't gruelling (if I didn't want a sibling for my daughter I'd have thrown in the towel by now), but to think that these pregnancies were never viable does give me some peace - that it was nothing I did or didn't do; my body was doing its best; there was no other outcome possible.

I do wonder whether I have more chromosomally abnormal eggs than Michelle Duggar, or if in an alternate universe where I was actively trying for a baby every year of my life, I'd be as fecund as her. The nuts and bolts of reproduction is a fascinating and mysterious world.

[just_ordinary]

1 hour ago, CarrotCake said:

In the Netherlands they are not allowed to give away the sex with the NIPT. Basically, you can know about all their chromosomes except for the X/Y-ones.

It is to avoid people choosing abortion based on the sex of the baby. It's sick that it has to be taken into account but I'm glad they do. After 13 weeks you can still get an abortion of course, but the process is different, it is not as easy anymore.

It’s the same here. You can abort till the second trimester for whatever reason (even though they make you attend I think two meetings with counsellors or similar to see if there are issues that keep you from going through with it and see if there is something that would help you). But you can still abort, nobody can take this choice aways from you. After the first trimester there has to be a medical reason: health of the baby (not exactly sure if it has to be a terminal condition), mental (often used by non terminal disabilities of the baby) or physical health of the mother. 
I think that’s an ok compromise that both sides of the spectrum can life with and that is accepted by the mainstream and only attacked by people at the ends of both spectrums. 
I do think there should be more education about it, so people know their options, what to do, what procedures are there and how they are done - that’s a hot topic even legally though. 
So I get why they withhold the sex from you till 14 weeks. BUT I also wonder if it is in the best interests of a baby to be born into a family that would have aborted it if they knew the sex? I also think about the question if it is ok to abort a baby that has a non terminal illness or disability. Our Down Syndrome community is actually asking very hard questions and there is no good answer. The question when a baby is a „life“ and what „life“ has the right to survive is not a one fits all answer to me? I mean what about babies that need help breathing after birth at full term vs a baby before term that would survive being delivered? Does it just have to be outside the mother or has the cord to be clipped? I find that unsolvable as I do absolutely support bodily autonomy but also being pregnant is as far from bodily autonom as you can go without being sick. I think our compromise is not ideal but good enough and I do believe women make good choices and therefore there is no real need to withhold that information but also no necessity to know, so you can accommodate the more cautious party here.

Edited October 18, 2021 by just_ordinary

[CarrotCake]

23 minutes ago, just_ordinary said:

So I get why they withhold the sex from you till 14 weeks. BUT I also wonder if it is in the best interests of a baby to be born into a family that would have aborted it if they knew the sex? I also think about the question if it is ok to abort a baby that has a non terminal illness or disability.

This is actually a very valid point. Is it 'worse' to abort a baby because of their disability than because of their sex? To be honest, I am not sure, even when myself have done the NIPT with the idea that I would probably abort if the baby had a serious disability. Thank god I did not have to make that decision but still... You can definitely argue whether or not a baby with a 'undesired' sex is better off being born or not.

Let's say I am happy I do not have to make ethical laws like this.

[feministxtian]

3 hours ago, CarrotCake said:

This is actually a very valid point. Is it 'worse' to abort a baby because of their disability than because of their sex? To be honest, I am not sure, even when myself have done the NIPT with the idea that I would probably abort if the baby had a serious disability. Thank god I did not have to make that decision but still... You can definitely argue whether or not a baby with a 'undesired' sex is better off being born or not.

Let's say I am happy I do not have to make ethical laws like this.

Even disability has a spectrum...would baby be able to live and function independently in the world, with or without ongoing help? Would that baby live a short life and unable to comprehend the world? Would baby be subjected to pain, endless medical procedures with no hope of improvement?

I've never had to face that, but based on friends, the decision is agonizing. I have a couple of friends who have had second trimester abortions due to conditions "incompatible with life" These were planned and wanted babies, but the 20 week ultrasound was not a happy one. One, the baby didn't have a brain, the other the baby had some issues with their internal organs. 

I'm not in favor of aborting due to sex. That just reeks of patriarchy. Although I may have been tempted after #2 son. Fortunately I didn't have to, nor will I have to make that choice. 

[just_ordinary]

There is also a spectrum in one type of disability possible. As I said our Down Syndrome community is very vocal and knowing that your child will have Trisomy 23 says nothing about if it’s a severe case or if they could live very independent with little outside help, even without you. I am also very happy I never had to make that decision, even though I know what I would have decided. I think it’s important that parents/mothers can make a decision but I don’t doubt humanity in itself benefits from some guidelines around it. And I could never sit on an ethics board to advise/consult/decide in those matters. If I follow the logical build arguments I more often than not end at points I personally don’t agree with- no matter what the starting assumption is. But I also think cherry picking is a weak ground for fundamental decisions and unsatisfying and hard to defend (dang degree in philosophy really made my life hard in that regard). There is a reason they are ethic boards and not moral boards. I do wonder if the ethical argument is in line with the morals of the people sitting on them, because my personal moral compass is not happy with the end point of the arguments. And if not, how they deal with it personally. The current solution is ok an appeases most, that’s why I think it gets acceptad by approximately 90%.

Edited October 18, 2021 by just_ordinary

[feministxtian]

Downs is not on my disability list. 

Ethical vs moral decisions are TOUGH! I've had to make some decisions that may not have been moral, but they were ethical to me. My 95 year old aunt with dementia went into heart failure. I could have told them to implant a pacemaker and she may have lived longer - the moral thing to do. The other choice was to make her comfortable and let her go. That was the ethical choice. 

Thing is, people get hung up on the moral and not the ethical. 

[medimus]

8 hours ago, CarrotCake said:

In the Netherlands they are not allowed to give away the sex with the NIPT. Basically, you can know about all their chromosomes except for the X/Y-ones.

It is to avoid people choosing abortion based on the sex of the baby. It's sick that it has to be taken into account but I'm glad they do. After 13 weeks you can still get an abortion of course, but the process is different, it is not as easy anymore.

Interesting. My baby boom group of friends above are in Belgium (Flanders specifically) so very close, but they do get the sex with the NIPT. But it isn't done until week 12, so you wouldn't have time to get the results before the deadline for abortion. The abortion laws are stricter in Belgium than in the Netherlands, only first trimester allowed for any reason and then for medical reasons thereafter. If that is for disability of the foetus, there is an ethical committee for each case (though down syndrome is an accepted reason).

[CarrotCake]

10 hours ago, medimus said:

Interesting. My baby boom group of friends above are in Belgium (Flanders specifically) so very close, but they do get the sex with the NIPT. But it isn't done until week 12, so you wouldn't have time to get the results before the deadline for abortion. The abortion laws are stricter in Belgium than in the Netherlands, only first trimester allowed for any reason and then for medical reasons thereafter. If that is for disability of the foetus, there is an ethical committee for each case (though down syndrome is an accepted reason).

Yes, there is quite a big difference. Here abortion is legal until 22 weeks but you will get counseling etc. I think up until 13 weeks or so it is rather easy.

But in Belgium they are also less strict on selection based on sex. A lot on Dutch couples go to Belgium for IVF because there it is allowed to select the embryos on sex (at least, it used to be, I’m not sure if it still is). Over here that is only allowed for people that carry a genetic disease that only passes on one of the sexes.

[medimus]

5 hours ago, CarrotCake said:

Yes, there is quite a big difference. Here abortion is legal until 22 weeks but you will get counseling etc. I think up until 13 weeks or so it is rather easy.

But in Belgium they are also less strict on selection based on sex. A lot on Dutch couples go to Belgium for IVF because there it is allowed to select the embryos on sex (at least, it used to be, I’m not sure if it still is). Over here that is only allowed for people that carry a genetic disease that only passes on one of the sexes.

I'm pretty sure sex selection in IVF is only allowed for PGD, for x linked diseases, just like you say is the case in the Netherlands. I would be very suprised if that wasn't true. It might have been different at the start, as Belgium was quite pioneering with feriltiy medicine.

Edit: added screenshot 'bij wet verboden' so yes illegal to select for sex unless for medical reasons

Edited October 19, 2021 by medimus
To add screenshot

[Smash!]

On 10/18/2021 at 2:53 PM, just_ordinary said:

Our Down Syndrome community is actually asking very hard questions and there is no good answer. The question when a baby is a „life“ and what „life“ has the right to survive is not a one fits all answer to me?

This is a very tough question and one that only the future parents can answer for themselves. I know I most likely couldn‘t handle a Down Syndrome baby for mental health reasons. Especially because there is less and less support from the government and I think it‘s hard to worry what would happen to your child when you die and are no longer here to support them.

On the other hand there are conditions like autism that are discovered when the child is already born and that can lead to needing lifelong assistance and support as well.

 

[just_ordinary]

16 minutes ago, Smash! said:

This is a very tough question and one that only the future parents can answer for themselves. I know I most likely couldn‘t handle a Down Syndrome baby for mental health reasons. Especially because there is less and less support from the government and I think it‘s hard to worry what would happen to your child when you die and are no longer here to support them.

On the other hand there are conditions like autism that are discovered when the child is already born and that can lead to needing lifelong assistance and support as well.

 

But could you claim the same mental health struggle if you know your child is sex x/y or with advancing testing methods has a high probability or definitely having x/y condition? What about blindness? And testing methods are improving all the time. Will the autism community maybe shrink like the DS one? I can definitely see that. Sometimes when we follow the logic way we arrive at points we don’t want to face. Is a baby with a detected condition a month before birth less deserving of a chance than a baby right after birth? They won’t make it on their own in both scenarios. As I said it’s really really complicated and I actually try to avoid thinking about it too much.

I would have very probably/definitely chosen an abortion in a case of a genetic defect (or others that might arise) but I am happy I don’t have to face it because if I think long and hard about it I fear I might not like what it says about me and how I view the adjective “life worthy”.

Edited October 19, 2021 by just_ordinary

[Smash!]

I definitely wouldn‘t care about the sex. And in my opinion it‘s less about deserving to be born than about what the parents are able to handle. For example a scenario like this: A baby with a disability born into a family with two existing children. Finances are tight with all the needed treatments, the siblings don‘t get enough attention because of it leading the parents to feeling guilty, the need to reduce working hours because someone needs to take care of said child etc. One could ask if it was fair to the existing children to knowingly bring a baby with known severe disabilities into the family.

This all in a scenario with little to no support. If government would support parents and disabled children more in various ways I‘m sure it would be easier for expecting parents.

 

[CarrotCake]

2 hours ago, medimus said:

 

I'm pretty sure sex selection in IVF is only allowed for PGD, for x linked diseases, just like you say is the case in the Netherlands. I would be very suprised if that wasn't true. It might have been different at the start, as Belgium was quite pioneering with feriltiy medicine.

Edit: added screenshot 'bij wet verboden' so yes illegal to select for sex unless for medical reasons

 

Thanks, I was already doubting whether or not it was still the case. I think the stories I know of are from a longer time ago. I just googled and now they 'advise' to go to Cyprus.

[fundiewatch]

I have a friend who had two boys with no intervention. She dearly wanted a girl so they did IVF, two embryos were obtained, one male and one female. She had the female implanted and the child is now two. She didn’t plan to have the remaining embryo implanted. Side note, she donated the embryo and the boy is now one. The families have contact. Anyways, totally legal. 

[theotherelise]

In the US it varies by state for IVF and sex selection. I did PGS testing on my IVF embryos and would have been allowed to pick sex for the transfer. We chose not to pick, but we did ask to know after our second beta came back good. So we knew it was a boy at 4w3d. I don't know if I'll go back and try another embryo transfer in the future, but my nurse let slip that our remaining embryos are 50/50 male/female. It's kind of fun knowing that we'd have the same odds as anyone else if we do try for another.

While doing IVF, I hate followed a woman on IG who had like 4 boys and was doing IVF to try and have a girl. 

[SassyPants]

4 hours ago, theotherelise said:

In the US it varies by state for IVF and sex selection. I did PGS testing on my IVF embryos and would have been allowed to pick sex for the transfer. We chose not to pick, but we did ask to know after our second beta came back good. So we knew it was a boy at 4w3d. I don't know if I'll go back and try another embryo transfer in the future, but my nurse let slip that our remaining embryos are 50/50 male/female. It's kind of fun knowing that we'd have the same odds as anyone else if we do try for another.

While doing IVF, I hate followed a woman on IG who had like 4 boys and was doing IVF to try and have a girl. 

Is that even industry sanctioned or insurance approved? 

[Mela99]

Is that even industry sanctioned or insurance approved? 

Insurance approved for gender selection IVF, rarely.

Industry sanctioned? Yeah. It’s done

[theotherelise]

@SassyPants Not every ivf clinic offers it. Insurance didn’t cover my ivf for diagnosed infertility, so I think people are used to the idea of paying out of pocket for ivf regardless of the need.

Im not in a state where infertility health care is covered, but I believe there are usually requirements before ivf is covered. Either you need proof of a lack of Fallopian tubes or you have to do so many IUIs first or there is a zero sperm count situation which requires TESE sperm retrieval and ivf. The woman I hate followed definitely was paying out of pocket. That was something she complained about 🙄

[SassyPants]

2 hours ago, Mela99 said:

Insurance approved for gender selection IVF, rarely.

Industry sanctioned? Yeah. It’s done

I could see for certain genetic disorders -

[just_ordinary]

I actually don’t get the problem with selecting a certain gender if you have to use IVF. And if you only go that route even if you could get pregnant and deliver successfully without medical help- by all means whatever. IFV is no fun. It’s incredibly hard on the woman’s body and mental health (that hormone cocktail and the emotions already present are no joke) and it’s not a guaranteed success. You have no idea how many mature eggs you score (unlucky women might end up with 0), if they will be actually deemed ok, if they take well to freezing, if they fertilise and if they will implant. If you are willing to go through that gamble to be able to say, but please only implant from the eggs that are XX or XY, I think why not? There are so many eggs unused (don’t know if they are just stored forever or till they go off or if they can be thrown out), who cares if some are unused because they have a certain sex or without reason? I also highly doubt that a big percent of people doing IVF do that to specifically get one sex. So my guess would be it’s about the same percentage as people that think abortion is a good method to prevent pregnancies- somewhere in the 0.0x range. The success rate is not that great and has many variables, you are probably just as successful by trying the conception window method and similar. The only benefit is that you are only really adding a new family member with a certain sex and don’t have a new baby with the undesired sex.

[AprilQuilt]

Chrissy Teigen and John Legend knew the sex of their babies because they were conceived via IVF - in that they had 2 viable embryos, male and female, and they chose to implant the female first (Luna) and then used the male when they went round again (Miles). There was a bit of a thing about it quite a few years ago. This article is quite interesting, and does make the point that there's a difference between having IVF for medical reasons and therefore knowing/choosing the sex of the implanted embryos; and having IVF in order to choose the sex.

It's hardly Gattaca at this point but I do side-eye that second instance. Like what else about your child will you wish to control? What ideas do you have about gender or how a family 'should' be? When they start expressing preferences beyond your control, how will you feel? The best thing my daughter has done for me is confound my expectations. She's blown the things I thought I wanted right out of the water. I'm grateful for that dose of humility.

https://www.vogue.com/article/chrissy-teigen-ivf-gender-selection-controversy-explained

[Meggo]

I went through multiple rounds of IUIs and tried to do IVF twice (hey there, body - who scoffs at medical intervention...) and I cannot image doing that simply for the gender of the baby to be a certain answer. I remember telling the doc one day - in the midst of all of it - that my brain had turned to swiss cheese and he said "oh yes - quite common... it'll come back" (it took YEARS for it to come back to some sense of normal). 
I remember trying to get the bubble out of my trigger shot needle and shooting it onto the cupboard and calling 911 (telling them this was clearly not an emergency but I needed someone) and going to a pharmacy late at night to get the med again and the pharmacist being worried I wouldn't be able to drive myself home because I was in such a state. Man... I don't wish that on anyone. 

In John Legend & Chrissy Tiegens case - they likely planned to use both anyway - so that's not really selecting FOR gender. 

[theotherelise]

The genetic testing itself is really expensive too. Ours was $6000 for up to six embryos and $200 for each additional embryo. That was in addition to the $14k for the retrieval, meds, and one transfer.