Things they don’t tell you about being pregnant

There are non-obvious side effects to being pregnant that either the books don’t want you to know or the women who give you advice conveniently forget to tell you to expect.  For some people these effects will happen more quickly than others; for me, a lot of them have happened in the last few months.  And for me, I’ve felt like the frog in slowly boiling water who realizes too late his sad, sad fate.

  • You will no longer be able to cross your legs.
  • Just when you think there is no way your abdominal muscles could stretch even more, they do.
  • You could wake up with the baby all on one side of your stomach.  Really.
  • The baby might kick / punch the crap out of you just to get your attention.
  • You will be unable to change your toenail polish on your own.
  • You will learn to shave your legs with both hands since you will be unable to twist your waist.
  • You will need help putting on your shoes.  You may even have to sit down to do it.
  • A day without heartburn feels as good as Christmas morning.
  • The baby could move in a way that sends sharp pains down your legs.
  • Driving will become precarious once you need to move further back from the steering wheel and you have trouble turning around.
  • In the wintertime, you will be the warmest person in the room unless there is a menopausal woman experiencing hot flashes.  You will think that the thin sweaters they sell you at the maternity store are worthless because they’re so light, but you would be wrong.
  • You will swallow your pride and: take the elevator (up and down), have that extra slice of pie, allow a stranger to put groceries in your car, allow your husband to do the housework.
  • Your dog will worry about you since you look so different; he or she may not even recognize you at first glance.
  • You will want to prop your feet up everywhere you sit (especially once you can no longer cross your legs).

There are a few books out there that my girlfriends swore by that are supposed to be no-holds-barred, tell-all books that shed light on pregnancy.  The one that I’ll endorse is Jenny McCarthy’s Belly Laughs, which is a super-fast read (I think I read it in less than an hour).  It was a little out of order chronologically, I think, but it was nice to hear that I’m not the only one who let out a sigh of relief when she switched over to maternity underwear.

Ladies, consider yourselves warned.

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Don’t ignore the data

  • Mullerian anomalies occur in approximately 2 – 3% of all fertile women; 3% in infertile women.  (Seattle Reproductive Medicine)
  • Unicornuate uterus anomaly seems to occur in 1 of every 4,000 women.  (Wikipedia; yes, I know – I hope this doesn’t discredit me)
  • The term pregnancy rate is 47% in women with unicornuate uterus.  (BabyMed.com)
  • The total fertility rate for women in the US is 2.01 children per woman.  (Wikipedia)
  • Male factor infertility can be a primary source of up to 35% of infertility cases.  (Resolve.org)
  • Up to 50% of cases of infertility respond to treatment (and result in successful pregnancies).  (Resolve.org)
  • Women who have taken fertility medications (such as clomiphene citrate/clomid) have a 3-4% risk of developing ovarian cancer, compared to a 1-2% risk in women who had never taken the medication.  By comparison, the average woman’s chance of developing breast cancer is 12%.  (Georgia Reproductive Specialists)
  • Women who took clomiphene citrate for more than 12 cycles had the highest increase in lifetime risk of developing ovarian cancer; women who achieved pregnancy while taking the hormones did not have as high of an increased risk. (Georgia Reproductive Specialists)
  • There are about 600 reproductive endocrinologists in the US.  (iVillage.com)
  • The first IVF baby was born on July 25, 1978 in the UK.
  • Since 1978, over 45,000 babies have been born in the US with the assistance of IVF; over 70,000 total have been born with some form of assisted reproductive technology.  (Discovery Health)
  • About 2% of the child population in the US are adopted.  (ChildTrendsDataBank)
  • About 3% of American families include adopted children.
  • Adopted children are more likely to be read to every day, told stories to, eat a meal with the family at least six times a week, and participate in organized activities.  (ChildTrendsDataBank)
  • Infertility is a factor in 39% of families choosing to adopt a child from foster care.  (US Dept Health & Human Services)

To learn more about infertility, please visit the Infertility 101 page at Resolve.org.

Click here to learn about National Infertility Awareness Week.

Clomiphene citrate – What your doctor doesn’t tell you

“How long have you been on Clomid?”

“This is my seventh cycle.  The first four were 50mg, now I’m up to 100mg.”

“Seven?” The physician’s assistant looked a little surprised. I know there are risks to being on clomiphene citrate for too long – risks of cysts, of ovarian cancer – but my OB/GYN didn’t seem worried with just one more month.  The PA, however, had a differing opinion – and given my side effects with clomid I’m not unhappy about it.

“How are you tolerating it?” was her next question.  I kind of rolled my eyes and scoffed, “Better with each month I’m on it!” She didn’t find it funny. I continued, “I get bloating mid-cycle around the time of ovulation, gained a few pounds…” I forgot to mention the mood swings – or maybe she cut me off before I could finish.

“Here’s how I feel about clomid. It’s not for skinny women. It works best in chubby young women.” She went on to insinuate that sometimes heavier women do not ovulate. “In my experience it hardly ever works in skinny women. And furthermore, if you’re going to get pregnant on clomid, it’ll happen within the first three to four months on it. I’m not a big fan of it. There are other medications and treatments we can use,” leaving unsaid that are safer.  Why was my OB/GYN so glib with my health by keeping me on this medication that made me miserable for so long? Why do the drug companies that make the stuff say mood swings, bloating, weight gain are all “very rare side effects” when every woman I’ve ever talked to who’s taken it experienced each one of those symptoms and more? One women I met at a fertility nutrition class admitted to having gained over 50 pounds on clomid and was forced to wear her husband’s clothes because she could not fit into any of her own and was resistant to buying fat clothes!

It is not hard to understand, then, why I am very much looking forward to next month – whether or not Aunt Flo comes (though obviously ecstatic if she doesn’t) – and being able to be comfortable in my own body once again.

This is your body on Clomid

About two weeks after taking Clomid – your midcycle, about the time you ovulate – your body starts rebelling against you in cruel and unusual ways.  My symptoms have ranged from bloating to cravings to painful intercourse, and the severity lessens the more cycles you do.  I have done 4 cycles of 50mg clomiphene citrate, and I am on the 3rd cycle of 100 mg.  (Apparently my body didn’t really ovulate during the 50mg cycles, according to my OB/GYN, though given the bloating and pain I experienced you could have fooled me!).  During my very first cycle, I thought I was having kidney stones I had so much pain in my lower abdomen.  I could barely sit down, stand, or move.  Going to the bathroom was extremely painful.  And it wasn’t gastrointestinal pain – it was far deeper than that.  It was awful, and it makes you not want to move for days.  The pain disappears in about a week, and with every cycle it isn’t quite so bad as your body gets used to it.  But still, it’s enough to make me wonder how much more patience I can have in being uncomfortable in my own body.

My abdomen becomes very bloated from mid-cycle through the onset of menstruation.  My pants don’t fit as they usually do, and I look like I’ve gain about 10-15 pounds in my midsection, though I may not be eating anything more.  I try to do yoga as much as possible during this time, since I’ve read that vigorous exercise could twist your tubes and disrupt your ovaries in this state.  But it isn’t enough to make me feel like my normal, skinny self again.  In fact, I won’t feel normal and fit into my skinny clothes again until the onset of menstruation.

In short, I go through two weeks of bloating, a few days of extreme abdominal/pelvic discomfort and in some cases pain, topped off with two weeks of self-loathing.  And lately, after over half a year of this emotional and physical roller coaster, the two-week wait is a pessimist and uncomfortable march to the inevitable.  I try to be positive – I exercise, I meditate, I pray – but somewhere deep inside I’m not convinced this month is the month.  Not since I got overly excited a year ago and bought the onesies have I had true, honest, authentic, and trusting hope.

This is your brain on Clomid

You know how you get those printouts at the pharmacy with your prescription that tells you all about your side effects?  You know how they say mental or mood disturbances are an extremely rare side effect?  Yeah, me too.

Don’t believe it.

Every woman I’ve talked to who has taken clomid (and for the record I am on generic clomiphene citrate) had warned me about the mood side effects.  Wild mood swings and depression were the chief complaints.  I didn’t believe them, because when I took the medication I didn’t feel anything.  It felt a lot like a sugar pill to me, with the lack of immediate side effects – compared to other medications which tend to make you feel woozy, drowsy, hyper, relaxed – in other words, make you feel something.  But when I started my first round of 50mg clomiphene citrate and I didn’t feel any differently – and didn’t notice any change in how I was thinking – I believed I had escaped that side effect.

In fact, it wasn’t until the second round of clomid that I began to realize, “Hey, this isn’t me.  This isn’t normal.”  Having suffered through depression on and off through my teens and 20s, I thought I’d be able to recognize the signs.  I was entirely fooled, until I started taking cheap shots at my husband and realized, “Stop! What did I just do?  And why?”  The worst thing was, acting so bitchy felt entirely natural to me even if it really isn’t my nature.

Here’s what I went through (and continue to battle, now on my second round of 100mg): A complete and utter lack of desire to go to work – every day. A negative view of everything happening – at my job, at home, on tv. I become a human Eeyore, a grey cloudy sky following me everywhere I go, drenching everything I encounter with sad and morose overtones. My husband can’t do anything right, and (exasperated sigh!) my life is soooooo stressful and overwhelming.  I couldn’t stand to be around anyone. Grrr!!!

The pharmacist ought to hand you a little placard with your prescription that reads, “Don’t mind me, I’m on clomid.” Maybe a warning sign is more appropriate.  But I advise informing those you love about what’s going on, why you might be acting strange.

Only you know yourself best.  So make sure that when you’re on any kind of medication that affects your mood, you keep up your usual lifestyle regimen that you have come to expect.  Keep exercising – it is the only thing that returns me to my “normal” state during the 5 day cycle of hormones.  Keep eating healthy foods.  And, if it makes you feel better, indulge yourself in a retreat: give yourself a pedicure, get a massage, or lay on the couch and do nothing – and don’t feel guilty about it.

One cognitive effect I have experienced which actually has a physiological impact is that it makes you think you’re hungry even when you’re not.  Maybe it is a psychological way to cope with the depression and mood swings, to eat chocolate and comfort foods.  But either way, I’ve had to train myself to stop snacking as often as I had been – because only a short week to 10 days after starting clomid, my body would begin to see the rest of its side effects.

To be continued…