I could see the blood pooling in the passenger seat. I tried reassuring my wife, but Jo Ann knew what was happening.
The emergency room admitting nurse validated our fears by inquiring, “How far along were you?”
The average number of eggs collected for in-vitro fertilization (IVF) is 12. Jo Ann had seven. The viable embryos created in the lab usually number three or four, from which the best one or two are introduced to the womb. Of the three embryos created for us, two died. The sole survivor was graded a “B” for unequal cell division. According to our fertility doctor, there was only a 20 percent chance of it implanting in the uterus, much less ever getting into Harvard.
READ MORE: The Fatherly Guide to IVF
In clinical terms, that’s IVF’ed up.
Okay, okay. So you have already guessed that our story ends well, but we didn’t have the luxury of your knowledge at the time. And even though we couldn’t have asked for a better ending than our daughter Skylar, frankly, a better beginning and middle would have been nice.
Prior to IVF were three failed artificial insemination attempts, heartbreak following hope each time. “I feel pregnant!” Jo Ann would beam. Then the cramps came.
Not only was Jo Ann in early perimenopause at the shocking age of 35, but (TMI alert) my swimmers were 97 percent misshapen due to varicose veins in my factory, which make the assembly line too hot to work. We were the Baron and Baroness of barrenness. (Actually, that would have been a better nickname than what my workmates called me for three years after I made the mistake of informing them about my testicle-vein thicket: “Hot Balls.”)
Jo Ann returned from her in-vitro fertilization weeping inconsolably into a pillow with our bedroom door closed for three days.
Before I continue, there’s something I must admit: Fatherhood was not something I needed to do in order to die a complete person. I thought of it more like teaching community college – something I could see myself doing someday, being good at and even enjoying if it happened. But it was never my dream, not even close.
Not only was Jo Ann in early perimenopause at the shocking age of 35, but my swimmers were 97 percent misshapen due to varicose veins in my factory, which make the assembly line too hot to work. We were the Baron and Baroness of barrenness.
Motherhood meant everything to Jo Ann, though. She even told me on her first date – along with something else designed to scare anyone off who wasn’t capable of ever becoming absolutely serious — and I’ll get to that in a bit, because it’s relevant.
But if having a kid was Jo Ann’s dream, then it was mine now, too. Only it wasn’t going to happen via either the natural or enhanced methods anymore. I had already decimated my 401k paying for the fertility treatments, which health insurance does not cover. So we called an adoption agency. Our appointment was scheduled for the following Wednesday.
Jo Ann called me a day before. She was weeping again.
“I’m pregnant,” she said.
The midnight dash to the hospital was a false alarm — although we wouldn’t know until our fertility doctor’s office opened at 6:30 a.m. (An ER physician discharged us without assurances, stating only that Jo Ann herself was in no immediate danger.) The fetus had tapped into a blood vessel that started leaking, but it was still healthy.
The real danger was Jo Ann’s cervix. She had been cancer-free for 14 years. But when she was 22, doctors discovered it in her cervix. And that’s the secret she told me on our first date. Valuing potential motherhood over her own life, she refused the prescribed chemotherapy and radiation. Three surgeries followed, each removing more of our future baby’s flooring. The third one got infected, requiring even more removal.
“You’ll just have to have a cerclage when you get pregnant,” she remembers her oncologist telling her nonchalantly, referring to a stitch used to prevent preterm labor due to incompetent cervix.
While searching for Jo Ann’s cervix, our new high-risk pregnancy doctor made an observation that surprised everyone — especially himself.
“Umm, it’s not there,” he said.
The Shirodkar cerclage is almost never used. It’s so much more invasive and complex than the traditional McDonald cerclage, its baseball-like stitches cannot be removed and the baby must be delivered by Caesarian section. It also requires strict bed rest for the duration of the pregnancy and foot massages administered by the husband every night. (Looking back, I think Jo Ann snuck that last one in there.)
The only people to whom bedrest sounds like fun are those who have never been ordered on it. Jo Ann could stand up for only 20 minutes every two hours, and travel was restricted either to the bathroom, kitchen, or doctor’s office.
Our high-risk doctor passed the baton to the partner in his practice with the most Shirodkar experience, a doctor who still had only performed three such procedures in his entire career. Like the fast food they sound like, McDonald cerclages are quick. They take 20 minutes. Jo Ann returned from the operating room after 90. Through an epidural haze, she recalled the Shirodkar doctor placing his foot on the bed for leverage as he yanked threads with strokes long enough for a rowing machine.
Six months of bedrest followed. By the way, the only people to whom bedrest sounds like fun are those who have never been ordered on it. Jo Ann could stand up for only 20 minutes every two hours, and travel was restricted either to the bathroom, kitchen, or doctor’s office. (One day, I came home from work, greeted Jo Ann and rushed upstairs to my computer to send an email. Jo Ann sobbed. I was the only person she had talked to all day and I didn’t want to talk to her.)
At 3 a.m. on a random Wednesday, Jo Ann flicked on our bedroom light. “Are you ready to meet your daughter?” she asked.
A clear and odorless liquid drenched her legs. There were no contractions, but she had been placed on anti-contraction medication to extend the pregnancy. We weren’t expecting to no longer be expecting yet; it was just shy of Jo Ann’s eighth month.
I jolted out of bed, then paced back and forth along the foot of it. Every seventies sitcom cliché consumed me: Do I boil water? Did we pack a bag? What the hell do you boil water for?
This ER trip was a much better one. My wife held my hand as the nurse took a sample of the liquid for a test. A half-hour later, the result came back.
It was negative. We were discharged, the nurse explaining: “We can’t give you a C-section before your due date if your water hasn’t broken yet.”
The next day, the flow increased. Freaked out, we returned to the hospital, where the test also came back negative. Discharge followed, yet again, by discharge.
What was this clear and odorless liquid? “We don’t know,” another nurse said, “but it’s not amniotic fluid.” If it were, she explained, the test would turn bluish-purple.
“See?” she asked, holding up something I couldn’t identify by anything other than its lack of bluish-purpleness.
Jo Ann had been monitoring the baby’s kicks with an iPhone app. The number was normal: between 10-50 per hour. From 2-3 p.m. on Saturday afternoon, there were none.
Jo Ann didn’t want to return to the hospital just to be sent back home again. I insisted, which is one of many things my daughter Skylar owes her life to.
Glucose and electrical stimulation were administered. There was no response from the womb. More foot-of-bed pacing followed. It extended out into the hallway. Oddly, I found our high-risk pregnancy doctor there. Although none of his offices are within 10 miles of the hospital, he just happened to be seeing a patient in the same maternity ward at the same time – which is something else Skylar owes her life to. We exchanged pleasantries, then he read our baby’s vital signs and ordered the emergency C-section no one else would.
Holding my wife’s hand while the surgery began, I made a promise I wasn’t authorized to make: that everything would be okay.
After 14 minutes, I peeked over the curtain and pointed my iPhone’s video camera. This pool of blood was a more welcome sight. Our daughter was being plucked from it, pink and crying.
I went from someone who didn’t need to be a father before he died to someone who will kill himself if something ever happened to his daughter. The change has been profound and shocking not only to me but my closest friends.
A NICU doctor manned a table by Jo Ann’s feet. Later, he told us he had been sent there to resuscitate. “We weren’t expecting a pink baby,” he said.
Another NICU doctor told us that, of course, the mysterious clear liquid was amniotic fluid. “What else could it have been?” he asked. (Later, we were told that the test is only 95 percent accurate.)
For three days, our baby endured an environment considered unsafe after 24 hours. This was probably why she was now suffering from a suspected lung infection.
Where most parents cry tears of relief at the birth of their first child, ours were tears of worry as 10 sleepless days and nights of antibiotics, tube-feeding, and a spinal tap were administered.
But in the seven years since, Skylar has been happy, healthy and relatively drama-free (with the exception of a dog food-tasting incident I don’t care to discuss).
In that time, one of our fertility doctors has become not only a friend but my wife’s boss. We grew so close with Dr. Said Daneshmand and his staff during our treatment, he eventually decided that my wife would make a great director of marketing for the San Diego Fertility Center. So she quit her career in law.
And now Jo Ann travels around the U.S. soliciting patients with an edge over most of her colleagues: Skylar’s story.
Me, I went from someone who didn’t need to be a father before he died to someone who will kill himself if something ever happened to his daughter. The change has been profound and shocking not only to me but my closest friends.
But I would rather leave you with a funny memory. Not long after we brought Skylar home from the NICU, my own father phoned for a heart-to-heart. I prepped myself to receive information critical to the fathering process, some sort of dad-to-dad download.
“So,” he said instead, “when are you having another baby?”