268 lines
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268 lines
11 KiB
Handlebars
<html>
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<head>
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<meta description="Five Years of Miscarriages" />
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<title> Miscarriages </title>
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</head>
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<body>
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<blockquote>
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There are moments that the words don’t reach
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There is suffering too terrible to name
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You hold your child as tight as you can
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And push away the unimaginable
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The moments when you’re in so deep
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It feels easier to just swim down
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</blockquote>
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<p>
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Since 2014, Sandy and I have been trying to have a child. We know now for certain that
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we will not be able to.
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</p>
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<p>
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In 2014, shortly after having been married by Elvis in Vegas on our way to Palo Alto,
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we started attempting to become pregnant. We had read the books, made all sorts of
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decisions. We'd use a midwife. We'd do a home birth, maybe a water birth. It didn't
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take long, Sandy became pregnant. We knew from some close friends who had a miscarriage
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before their first successful child that we should wait until 12 weeks to say anything,
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because that's the period when things are riskiest. We went for the ultra sound.
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</p>
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<p>
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When you go for an ultrasound, you expect to see something that doesn't actually look
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like anything recognizable but which the technician will inform you is an embryo. If
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you're lucky the first time, you might even hear a heartbeat.
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</p>
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<p>
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What you don't expect is for the technician to keep clicking around, measuring what
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looks like an outline, and eventually tell you there is nothing there. You don't
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expect to have a Blighted Ovum.
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</p>
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<p>
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Incidentally, you also expect the ultrasound technician to have some shred of empathy.
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But what you might start to learn is that the things you expect are not in concert with
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reality.
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</p>
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<p>
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A good friend of mine told me that the Zen Buddhist definition of suffering is the mismatch
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between expectations and reality. I don't know if it's actually Zen Buddhism or not, but
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I'll go along with the definition at this point, because all of the ways in which reality
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was diverging from our expectations weren't not suffering.
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</p>
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<p>
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We waited for it to miscarry by itself. When that happened, it being our first time,
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we went to the ER and learned that the ER at Stanford Medical Center is the
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Marc and Laura Andreessen Emergency Department. It was very nice, but it turns out
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there isn't much they can do. The on-call OB, however, happened to be EXCELLENT and
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became our new OB.
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</p>
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<p>
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That's good, because this set of unexpected reality wasn't done with us. Sandy had a DNC
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to clean things out, and in the follow up blood testing her HCG levels weren't going down
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properly. That's because the little Blighted Ovum had decided to become Gestational
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Trophoblastic Disease. Essentially, some of the cells embedded themselves in the uterine
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wall and continued dividing. Like Cancer.
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</p>
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<p>
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The treatment, also like Cancer, is chemo. Methotrexate injections. The last injections
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actually happened during the Paris OpenStack Summit, so we got to experience getting
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chemo injections in a foreign country. Sandy has a wonderful story about how this affected
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her experience of L'Auberge Du Pont De Collonges, but I'll leave that to her.
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</p>
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<p>
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That was a lot to deal with in Palo Alto. We moved back to New York.
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<p>
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After chemo for your gestational trophoblastic disease, you have to wait a while before
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trying to get pregnant again. We had <em>literally</em> just start trying again, which is why
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it didn't occur to us that Sandy was pregnant. (we now know that "my boobs hurt" is a great
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indicator, and doesn't mean "it's time to go bra shopping")
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</p>
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<p>
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I was in Mexico City for OpenStack Days Latam 2015 when I learned that Sandy was pregnant
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again. The way I learned is that on my way to the venue in the morning, I got a phone call
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from Sandy's good friend Shantel telling me that Sandy was in the hospital, having been
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taken there in an ambulance the night before after rupturing a fallopian tube. I booked the
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next flight back to New York and rushed back to New York.
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</p>
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<p>
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Sandy almost bled out. By all accounts, given the amount of blood she lost to
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internal bleeding, she should be dead. Woodhull Medical Center in Bed-Stuy is not nearly
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as pretty as the Marc And Laura Andreessen Emergency Department. People in the area call it
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"Woodhell". The blinds on the door to Sandy's room were broken and were partially replaced
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by a sheet that had been tacked up onto the door. This is, of course, because Bed-Stuy is
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a neighborhood full of brown people who don't deserve the same medical care as the folks
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at Cougar Night on Sand Hill Road.
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</p>
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<p>
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But here's the thing. The doctors at Woodhull are fierce, and Sandy is alive. If I ever get
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billions of dollars for no good reason, I'm totally going to endow a Sandra Trahan Emergency
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Department in Woodhull.
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</p>
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<p>
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After this, I'm going to be honest, it starts to run together for me. We had some more normal
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miscarriages. We went and saw Hamilton. We moved to Dallas. We saw a heartbeat once, then
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miscarried, which was life reminding us that we weren't numb yet and that it was still
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possible to punch us in the face.
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</p>
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<p>
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Then we hit a patch of, for the first time, not immediately getting pregnant as soon as
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we started trying. So we shifted our focus to IVF.
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</p>
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<p>
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If you haven't been lucky enough to go through IVF, it's almost as much fun as Gestational
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Trophoblastic Disease, but with more needles. As part of perparation they sent Sandy to
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a hemotologist, where we learned that she has two clotting disorders. This means if she gets
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pregnant we have to start injecting her daily with blood thinners. But before we get to that
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we get to inject her with all of the IVF drugs.
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</p>
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<p>
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If you haven't been lucky enough to need to inject your partner with multiple needles
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every night, I don't have anything clever to say. It sucks. It was, of course, worse for
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her.
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</p>
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<p>
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This is followed by the egg-extraction surgery. We got three almost viable embryos. None
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of them took. Our IFV doctor noticed some scar tissue around the cervix from all the DNCs
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we'd had to do and scheduled a surgery to take care of it before the next time. During that
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procedure the doctor discovered some tissue in the uterus that had been hanging out there
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since the last DNC. Kind of like the first time except this time with less cancer.
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</p>
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<p>
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Incidentally, our FIRST IVF doctor did a bunch of expensive tests, found elevated levels
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of inflammation (maybe actually due to the extra tissue laying around?) and recommend Sandy
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try removing Gluten from her diet.
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</p>
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<p>
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Gluten.
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</p>
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<p>
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By this point, we didn't have any remaining insurance for additional IVF, which isn't not related
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to all of those expensive and pointless tests, but also isn't not related to having an almost
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offensively but definitely absurdly low lifetime cap on our IVF benfits. Why would anyone properly
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fund women's reproductive health? We decided to take a break.
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</p>
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<p>
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Nope.
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</p>
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<p>
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Right as we were starting to settle in to the idea that this just might not work out for us
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and start the process of healing, we got unexpectedly pregnant. Now that the extra tissue had
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been removed, we were back to being very good at getting pregnant. Due to Sandy's blood clotting,
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this meant blood thinner injections. Nightly. In the belly.
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</p>
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<p>
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The injections hurt a lot, and produce purple bruising. The blood thinners have impacts on
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Sandy's psyche.
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</p>
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<p>
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It should come as no surprise that even with the blood thinners, and even with the extra tissue
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being gone, and even with the gallons of prenatals ... we once again miscarried. You'd think
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we'd be old pros at this this time, but it was one of the more cruel ones. We had just about
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hit a point of healing and acceptance, then we were given hope we weren't looking for again,
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then it was once again dashed.
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</p>
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<p>
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That was last year.
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</p>
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<p>
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This year, in early February, right around our three-year annivesary of moving to Dallas,
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we got accidentally pregnant again. We'd been EXTRA cautious, but that apparently doesn't mean
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anything. We knew it wasn't going to work, because let's be honest here -- but we also knew that
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due to the clotting disorder we'd need to give Sandy blood thinners for a pregnancy that wasn't
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going to be viable or else she ran the risk of throwing a clot and stroking out.
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</p>
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<p>
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Acceptance comes at strange times, and it was at this point that we realized that we were, in
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fact, done. We did not have it in us to fight this uphill battle anymore. It was time to choose
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to be Child Free, instead of simply suffering being Childless.
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</p>
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<p>
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Oh wait, did I mentioned we'd moved to Texas? Let me tell you something we all know, but which
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I have recently been reminded of first hand.
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</p>
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<p>
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Texas Lawmakers hate women.
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</p>
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<p>
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Not only is it illegal for our OB to perform an abortion for us on a pregnancy we know isn't going
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to be viable and that we don't want without waiting until we're far enough along to possibly
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hear a heartbeat, once we wait for that magical humiliating moment of going in to the ultrasound
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clinic with all of the happy pregnant women and getting our non-viable ultrasound result,
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it is then illegal for our OB to prescribe the chemical abortion pills in the way that is actually
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effective as recommended by the WHO. (incidentally, if you're in Texas and your OB tells you to
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take the pills orally, ignore them. Taking them orally carries a side effect of nausea and is also
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less effective. Take the vaginally. Or, rather, go Google what the WHO recommends and do that.)
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There is no valid reason to take them orally, unless your goal is punishing women who have had
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the temerity to become pregnant inappropriately.
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</p>
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<blockquote>
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If you see them in the street, walking side by side, have pity
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They are trying to do the unimaginable
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</blockquote>
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<p>
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We are now Child Free.
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</p>
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<p>
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I got a vasectomy, so that we don't have any more accidental pregnancies,
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what with them being life-threatening for Sandy and all. I can report that my procedure was sort of like
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going to get a latte, because I'm a dude, and of course medical science is going to figure out
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how to make my tiny procedure as absolutely painless as possible.
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</p>
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<p>
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I am at peace with our choice and happy about what's next. I still have all the emotions.
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I obviously have some anger. I'm devastated that I won't get to raise a kid. I'm sad that I won't
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get to give my parents grandkids, which is doubly-hard since I am an only child. (I'm also adopted,
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because my parents also had issues so they can empathize with our plight as well as anyone.
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Yes, we looked in to adoption. No, we don't have the emotional strength left to do it)
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</p>
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<p>
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I'm also grateful that I have a partner I love and who loves me. I am excited to continue
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to build our life together. It's not the life we expected to build, but I accept the life that it
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actually is.
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</p>
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<blockquote>
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There are moments that the words don’t reach
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There is a grace too powerful to name
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We push away what we can never understand
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We push away the unimaginable
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</blockquote>
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<small><em>Lyrics from "Quiet Uptown" by Lin-Manuel Miranda</em></small>
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</body>
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</html>
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