Pt 2: Calling in the specialist

I wrote the last blog the morning of my anatomy scan – the next events had me so stunned that I didn’t post it.

In the movies, it seems that every doctor’s appointment a pregnant person is getting an ultrasound. I was surprised in pregnancy that there is a confirmation ultrasound and then the anatomy scan. Knowing this would be one of the last glimpses into Baby D’s world – I was eager to hear how he was doing. The romance dissipated quickly as I laid on the table, warm jelly on my stomach. I couldn’t see a thing but a white ceiling.

I felt jealous that my husband could see all of the pictures that she was taking. I felt annoyed that the ultrasound tech talked in baby coos and clichés without any reference to what she was actually seeing. Tell me what organs you see, woman!! How many kidneys?!?

Fine, we’ll wait for the doctor.

My husband and I had planned a romantic cabin away for the weekend to celebrate halfway through pregnancy and hearing that the baby looked ok. It wasn’t to be arrogant, it was my focus on remaining calm and optimistic.

“Everything looks good,” the doctor began, “except we can’t tell if the heart vessels cross. You’ll need a level II ultrasound.”

I felt dizzy. My own heart paused. I was surprised by the hot tears on my cheeks. I’ve remained calm for the past months, and now when I opened up my mouth to speak, no words were coming out.

She handed me some tissues – it’s weird to be on the other side of health care.

She gave some generic comfort – stating they want to be safe since they couldn’t get a good picture. She didn’t think anything was wrong – but can’t tell for sure. Again, no specifics.

I was so embarrassed by my emotional outburst, that I focused on regulating my breathing and getting out of the office as fast as possible so I could cry in peace in the car. And I did.

And then I had questions. A lot of questions. But only google to help me.

I did what any rational human being would do – went home to further read on the heart disease I decided it was, evaluate centers, pick surgeons. I read the pregnancy message boards I thought I had sworn off. After the rational decisions were done (yes, I use that word ironically) – I did spend the rest of the week recentering.

I found myself whispering in the halls “please don’t have a heart condition, please don’t have a heart condition.” But when I took stock, I knew if the heart condition was there – nothing could change it now, especially not my desperate cries.

I tried to take my own therapeutic advice. Worrying about what I don’t know does not help. I filled the week as quickly as I could – worked good hours, exercised a bit more, picked out furniture, cooked more elaborate meals.

7 days of self-therapy later, my appointment arrived at Ohio State University. My husband and I joked around in the waiting room, trying to keep things light.

The ultrasound tech began – and I told her what the concerns were as well as my employment background. She nodded in understanding and started with the heart. Vessels clearly cross, blood flow looks good, all chambers there, no extra fluid.

The best exhale. I might marry this tech.

She spent the next thirty minutes going through every organ and bone measurement. There was a big screen in front of me and she explained each thing she saw and what it indicated.

What type of heaven is this place? I wondered.

I’ve never been so appreciative of anyone in healthcare in my life.

We are lucky. We know that. Congenital heart disease is sometimes genetic, often random, and rarely preventable. My story is common – but the “other” version still lingers with me.

The experience taught us a lot. I have regrets on my end for not advocating better for myself. I wish I had asked the doctor give me a minute to have an emotional reaction so I could have asked the questions that I needed –  I wish I had pressed more for concrete information, statistics, research studies.

It was a strong reminder of what the families I work with go through – and that they are the true heroes each day. It strengthens my advocacy for working towards care that prioritizes family needs.

As I’ve written this blog I’ve tried to come up with some poetic ending, and none have been quite elegant. But maybe that is the point. This is not an ending, this is a blip on the journey to meet our son (and a pinpoint in the story of his whole life). Parenting is scary and an ultimate testament to giving up some of the reigns. We’ll see what happens next.

 

Part 1: It’s called an anatomy scan

I work with Sick babies

I am a pediatric psychologist. What that means is I spent ten years of college studying human development and emotion, earning a PhD in Child and Family Psychology. The ‘pediatric’ part comes more from the experience and training more than the coursework – practicing in medical settings. My colleagues and I all specialize in providing mental health care in the context of facing acute and chronic illnesses. We still need to know how to identify and treat behavior problems, anxiety, and depression – but also within the framework of a family with multiple medical appointments and hospitalizations, painful procedures, and daily medication regimens.

Half of my job is meeting with children and their parents one-on-one in my office to address these concerns and help families navigate the best way to alleviate some of the struggle.

I’m here to talk about the other half of my job, which is in the cardiology intensive care unit. This is a specialized hospital floor for families of children with heart disease.

Heart disease is often talked about in terms of the obesity epidemic, but this is not what brings families to us. I see the families of children born with congenital heart disease — which means that in the early stages of utero development, the heart has developed differently. This could mean that certain chambers of the heart didn’t grow, different veins and arteries may be switched, or perhaps a valve leaks. Congenital heart disease impacts 1% of babies born each year.

1% may not seem like a lot. Until it is your child.

Actually in 2015 there were 3.98 million babies born, so that is almost 40,000 parents’ children each year.

If you divided that up by 50 states, that is 2 babies every day in each state.

Families usually find out their child has a congenital heart condition at the 20 week scan. Yup, that moment that parents dream of going to the doctor’s office to see if little one is a boy or a girl turns out to be the day the world flips. To look at that scan and hear that part of your child’s heart didn’t grow, he/she will need surgery only a few days old, and we can’t predict what the medical, emotional, or cognitive outcomes will be is numbing.

My role is small in this picture. We have a team the size of Texas to support these children – surgeons, cardio intensivists, cardiologists, nurse practitioners, discharge coordinators, social workers, child life specialists, nutritionists, and occupational/speech/physical/music therapies all come together to rally behind these children and promote their development in every way we can.

It helps. It doesn’t cure the fear.

Parents sit on the unit, next to tiny babies on ventilators, with chest tubes, with pacer wires, with IVs, with feeding tubes, watching closely over their little ones. These parents define strength. They support each other, they support themselves – they allow others to come in (such as myself) and provide support.

The true vulnerability and love on the unit humbles me every day and it is an honor to be part of these children’s stories.

These kids fight. Their parents press on. You see the good in the world as others say just the right thing. Bring just the right comfort. Parents find their voice.

The 20 week scan is an anatomy scan. It is a time to look at a developing child’s brain, kidneys, heart, bone structure and give a glimpse into what we can identify that may be developing as planned and not planned.

It is not a gender scan, and feeling that way is a privilege that can’t be overstated.

I’m so happy for many parents who have a quick check in this date and learn whether they can release pink and blue balloons in the air – but please take a second and think of the moms and dads who are going home to pick surgical plans, call insurance companies, and make appointments with specialists.

I write this the morning of my anatomy scan. I sit with my cup of coffee, a candle lit, and take slow breaths. I wonder about him, this little person growing inside of me. No one wishes for an unhealthy baby. We all know an unhealthy baby is still loved. And I do love him. I don’t know what battles he will fight, today will just be a snapshot of the early things we can predict in his life. I go to the scan fueled by the power of the mothers and fathers on the unit that love their children to a depth I didn’t know was possible until I saw it myself.

I write this in order to help others take a pause. It isn’t a gender scan.

 

 

Pregnancy Recommendations Are Confusing

Early on in our fertility adventures a close friend gave me the timeless pregnancy staple: What to Expect When You are Expecting. I had saved it on my shelf for over a year – not wanting to read until there was something I was actually expecting.

Shortly after I found out I was pregnant I opened the book – so excited to learn how to best support my baby. While I did learn a few interesting things (did you KNOW that baby’s intestines can grow in the umbilical cord and then move into their body – WHAT?!), I generally felt flabbergasted. Much of the words I read were contradictory and confusing.

Take exercise: The book lists off all the benefits of exercise and why it is important – then says, If you don’t exercise, you’ll probably be OK.

The next paragraph followed this same mentality – drinking caffeine is linked to negative consequence, negative consequence, negative consequence – but if you do it you will probably be OK.

And this continues through all of the recommendations.

I would look up to Rob and say “Well which is it? Should I or shouldn’t I?” These recommendations felt unsupported and it was hard to tell what was the most important.

I did what anyone would do – googled it. But that is met (much like fertility planning) with message board after message board thread of well-intentioned but possibly misinformed people. Much of the opinions on these boards are extreme (e.g., one sip of alcohol during pregnancy will result in fetal alcohol syndrome) or biased by personal stories or preferences.

Given our background in research, my husband and I wanted a deeper understanding of what the science really says.

Then I found the new pregnancy bible: Expecting Better by Emily Oster, a professor of behavioral economics in Chicago. The author talks about decision making in a two-part sequence:

First, gather all of the information – yet critically. She evaluates all of the research she can find on each subject, while taking into detail how good the studies are. Did they use enough people to draw these conclusions, were there other factors that should be considered, does the sample represent most pregnant women?

Second, she discusses how we all have to make our own decisions based off of perceived benefits and risks. Take driving to work every day. We know there is a risk of being in a car accident on a daily basis, increasing in inclement weather. On a snowy day we have to decide whether to go to work weighing the risks (car accident, death, spending 3 hours in traffic) with the benefits (getting paid, keeping one’s job, not falling behind at work). We weigh these “pluses” and “minuses” essentially to make our decision. While many people choose to go to work on these days, some may feel the risk is too great and choose not to. And both are OK.

I loved the premise – good, critical research evaluation and then let the consumer make their own decision.

Let’s take an example – caffeine. There is no consistent recommendation on caffeine consumption for pregnant women. The American College of Obstetricians and Gynecologists says 200 mg per day, while Australia says 300 mg per day, yet the Mayo Clinic says 0 mg per day. So what is right?

It is thought that caffeine consumption could lead to miscarriage. However, when Emily Oster pulled a wide range of studies and critically evaluated the research, it seemed that there is no conclusive evidence that moderate caffeine is linked to miscarriage. There is an increased (yet small) risk of miscarriage if consuming 6-8 cups of coffee per day.  Most studies look at women who drank under or over 200 mg/day. The concern here is that it is an arbitrary cut-off. Is 250 mg/day or 300 mg/day significantly worse? We don’t know, but seems unlikely.

The book goes on to show data (in easily understood terms) that supports washing fruits and vegetables, avoiding unpasteurized cheese, and that kegals can have long-term benefits. Her conclusions also support that eating fish (high omega-3, low mercury), most deli meats, and consuming up to1 glass of alcohol per day and caffeine are likely OK.

While there is criticism of the book – many feeling angered that her refuting commonly accepted recommendations is dangerous – I think this misses the point. Emily Oster’s point is to let the informed consumer make their own choices. For example, she states there has only been one outbreak of listeria linked to turkey. Knowing this, one can decide to eat or not eat turkey.  If you follow this logic, ice cream would also be banned for pregnant women, given recent listeria outbreaks. But that would be crazy talk!

Another struggle is that media often misrepresents science (John Oliver has a great summary presentation here). When the headline reads “Coffee Can Cure Depression” one may make a swift U-turn to Starbucks to beat the winter blues. But if you read the science the article is based off of, the data often say you need 6 cups of coffee per day to find significant effects, which is more than the average Joe drinks.

When I finished the book I took away two messages:

(1) We need to do our own investigating to make the decisions that we feel comfortable with. This does not mean finding people who agree with what we want, but looking at the good science that is out there to make the best decisions we can. With all of the pregnancy joy and excitement, also comes judgement and shame. “Oh, you are still drinking coffee?” “You know you shouldn’t be eating that?” “You had a sip of alcohol? Why not just hand the infant a beer?” Taking the advice as a whole, I often go days with no caffeine, and don’t stress if I hit 350 mg on another day.

(2) We need to know more. Science in this area is difficult. Our ethics tell us we can’t assign some women to only eat listeria-linked food to really test the chances of listeria infection, so researchers have to do the best they can with what they can observe. But we still need more studies and more replication before we draw drastic conclusions. Given that women are giving a year of their life to grow this baby – we owe ladies to know more, we owe our future children.

We Are Pregnant!

Rob and I are happy to announce that we are pregnant! We are expecting a baby boy in early July, 2018.

We thank everyone for their support and following. I plan to provide many more updates soon.

A quick note:

Many may wonder about our adoption – I assure you that is still on. We are on “pause” with our adoption agency until our first Baby Dempster arrives, and then will re-activate for Baby Dempster Numero Dos!

 

 

 

#Grateful

I’m not very gushy — I prefer sarcastic jokes and being silly. Yet with thanksgiving this past week, I have been reflecting on the past 17 month journey Rob and I have embarked on in our quest to grow our family. There have been some sad, dark, and angry times. Moments of frustration and exhaustion. Nights of feeling no one could possibly understand what I was going through. As we move forward, however, I remember a lot more of the good – and maybe it’s time to highlight that a bit more. In the whole journey, there is a lot to be grateful for.

I’m grateful for doctors who believed me. A lot of women go months, back and forth with their providers, trying to move forward with different fertility testing. Before I hit the arbitrary one-year mark that most doctors make you wait, my physician agreed that things were wonky and trying medication early would be appropriate. I’m grateful she laid out plans A, B, and C (still getting to D and E J) – it gave me a sense of calmness knowing there were different avenues we could take.

I’m grateful for scientists. Tireless work since long before I have been alive have allowed scientists – both practical researchers and clinicians – to learn more about fertility. I’m glad there are medications, tests, and procedures that have been developed to help so many of the families around us create their own little ones.

I’m grateful for my community – the friends and family who have rallied behind us. Some of you know most of the sordid details, some are just joining, but I have experienced nonjudgmental, overwhelming love and support. The brave families who have shared their stories, thoughts, and plans have made me a lighter and brighter person. From feeling so isolated and ashamed, I feel whole and full – no matter what the future brings. We are stronger together and I am humbled by your outreach.

I’m grateful for my husband. I have always felt we had a strong relationship, but the conversations, procedures, appointments, and trainings we have been through recently show how much deeper that love, trust, and support can go. We’ve had to share some dark fear, biases, and maybe unrealistic hopes – and I feel we have found such a loving and calm space to process these moments. I am very in love with him.

Feeling down is normal – especially in the midst of great strife. I’m not one to advocate for pretending to be happy, but I try to feel the gratitude on the good days.

Wherever you are in this journey of adulthood – know I am sending you strength, support, and hope. Life is serious – but I hope it can still be fun too.

 

My Brain & My Uterus Are Not Friends

This story unfolded in waves, with each cycle teaching me a new struggle I would have with my body and mind, so I shall write in that way. Apologize for length – there is a lot to go through. I want to start with a disclaimer – adoption is not our second choice. I’ll share more later, but adoption has been part of our plan for years before our fertility adventures. This is not a back-up kid for us. That being said, over the past 15 months I have learned one thing: My brain and my ovaries are not friends.

Stage 1: Problems Loom (AKA Warning Signs)

I knew pretty quickly that fertility was going to be a struggle for me. Many of my friends have been pregnant after only a few cycles, and when it didn’t happen for me I started to investigate. I read the Fertility Bible and soon realized that my cycles were not regular for many reasons. To give a brief overview of fertility:

A typical cycle is 28 days (day 1 being the first day of a period). In the beginning of a cycle, estrogen and progesterone levels are low, which stimulate pituitary glands (in your brain) to release Follicle Stimulating Hormone (FSH) which matures the eggs in the ovaries. Mid-way through a cycle, as estrogen surges, the pituitary gland releases lutenizing hormone, which tells the ovary to release the egg for (hopeful) conception. The estrogen also helps the body make super cervical fluid to help the sperm swim. If intercourse is timed right, the sperm and the egg meet up in the fallopian tube, do a happy dance, and move their way on down to the uterus to get comfortable and grow a baby. If this does not happen, Aunt Flow debuts.

To promote conception we did the following:

• Tracked cycle days on an app
• Peed on an ovulation predictor kit (OPK) for 1-2 weeks looking for when the surge occurs to time intercourse
• Checked out the mucus (yes, it is as awkward as you think)

As things still didn’t progress, we upped our game:

• My cycles were ~35 days, a week longer than typical. Continued tracking.
• We noticed that I had multiple positive OPKs, which probably meant that at times my brain sent a signal to my ovary and it said “solid pass” on releasing an egg – and then it would have to send the signal again a week later. That means a lot more pee sticks.
• We began temping — taking your temperature at the same exact time every day. Your body temperature will rise by ~.5 degrees if you actually ovulated, so this helps confirm ovulation, but also means 6 AM wake-ups on Saturdays.

Then it happened: Anovulation.

This is when an egg never comes out of the socket and, thus, you don’t have a period because the right signals aren’t happening. The first time this happened it was a 50 day cycle. The next time, 70 days. That means 120 days “trying” for a baby, but being stuck at the start gate because your engine isn’t running. It is as infuriating as it sounds.

Stage 2: Preliminary Testing (AKA Appointments Begin to Increase)

I am fortunate my doctor agreed to start the investigation process early given the above info. She ran some blood work (all normal). Honestly, so much blood work. Every time you finish a sentence just assume I got blood work. Ok, that was dramatic, but for the past year I’ve had a lot of blood work.

Next, Rob got the swimmers checked out – normal.

Then I had an a hysterosalpingogram (to the tune of supercalifragi…). This is where you lay in an xray machine and they squirt dye inside of you to check and see if your uterus to fallopian pathways are open. It was AWFUL. When the radiologist told me to breathe I gritted my teeth and was like “I KNOW!”  Six hours of pain on the couch to reveal that my tubes are (wait for it…) normal. Good news, but no direction.

Stage 3: Medication (AKA The Time I Lost My Mind)

My doctor started me on a medication called Clomid for 5 days per cycle. This is a common medication used to promote ovulation by blocking the estrogen receptors in the hypothalamus to help release the FSH and the LH.  The hypothalamus is the hub for hormones, including what regulates temperature, thirst, hunger, and emotions. This drug makes you cray cray.

I had hot flashes ALL DAY. Trying to do therapy when your insides unpredictably start burning from the inside out will make you think you are nutty. There’s nothing like looking around the dinner table and being close to tears as people say “No, it’s not hot in here.”

Besides that, I think I was a gem — but my man says I may have been moody… jury out J

Spoiler…after 3 months, no baby.

Stage 4: Referral to the Reproductive Specialist AKA Bring in the Science!

Rob and I met with a very nice doctor who wrote down everything above and asked about our medical histories.  He seemed pretty confident as he laid out the next plan.  He also told me to throw out my app and thermometer. It was like he could tell that I was a Type A planner, because he leaned in close, made eye contact and said “I’m serious, I don’t want to know a single temperature.” Big breath. The new plan we embarked on:

New Medication: I began a medication called Femara which is an off-label medication used for breast cancer. It has had better results with significantly less side effects – just a few headaches and fatigue for me. I do not miss hot flashes.

New Stimulation 1: I also began coming to his office for ovary ultrasounds. This means poking an ultrasound wand up your Va-jay-jay and pushing hard on your ovaries to count the follicles. He tracks the size of them and predicts when you have one ready to go. This sometimes means last minute appointments and 2 ultrasounds per month to get it right.

New Stimulation 2: Things get technical here. As we approach ovulation, Rob injects Pregnyl in my arm which helps trigger that ovary to let go of the follicle (because my brain typically forgets to tell it) in almost exactly 36 hours. You can time intercourse down to the hour from there. #Science

Stage 5: More Science (AKA This is Where it Gets Weird)

After the first two cycles of this, we were still not pregnant. The doctor also noticed my progesterone numbers weren’t quite adequate. While this would not mean as much for stimulating ovulation, progesterone levels keep the uterine lining thick to give the fertilized egg a good thick cushion to implant and make a home in. So another medication would be added to the regimen. I was like “fine, load me up.”

Then I called the nurse.

“Ok, you are going to take this medication twice per day (morning and night) vaginally for 10 days.”

Come again?!

“Where?”

She repeats.

“Where?”

She repeats. As you can guess I have 1.5 million questions.

And thus here I am, twice per day, throwing some progesterone up my V. If I do get pregnant, I will be doing this for the first trimester to help keep a baby in there. Wowza.

Stage 6: To Be Determined

After this cycle we will be meeting with the physician to talk about how my brain and my ovaries must have had a super big fall out somewhere along the way in my life, because the science is not making them friends! It has been 16 months. There are still some interesting options to try – but at times I feel overwhelmed and want to hit pause. Here’s to the next conversation and making decisions…

The Social Worker is Coming!!!

For two months I think I ran around the house pulling a Paul Revere: “THE SOCIAL WORKER IS COMING! THE SOCIAL WORKER IS COMING!”

I have no reason to scream this. I work with excellent social workers who I am lucky to call colleagues and friends. They are kind, informative, and supportive. Yet something about knowing that someone is coming to my house to evaluate me led me to spend hours cleaning the corners of the guest bedroom closet, the blinds and windows of every single room, and the pantry and freezer. Things got pretty intense, but boy-oh-boy was this house clean.

Looking back, focusing on cleaning out every cupboard and shelf gave me something to channel my family energy on. Can’t calculate how many days until you can take a pregnancy test if your head is in a bucket of bleach, amiright? And so we cleaned.

What I didn’t know is that the social worker would hardly look around the house. She made sure it was free of general clutter, flushed the toilets, and verified the fire inspection. Her real focus was to better understand Rob and I – including our family background, child rearing perspectives, and goals for the future. Over the course of two interviews we spoke with her for over 5 hours and here is just a few of the questions asked (there are pages and pages if anyone would ever like to see):

• What is your education background? Describe your medical and mental health histories.
• What significant life events have occurred and how do they impact you?
• Discuss your fertility issues.
• What are your future goals (educational, career, relationship)?
• Give evidence of your ability to delay gratification.
• How do you handle stressful and “impossible” tasks.
• Give examples of how you can interpret non-verbal and behavioral cues. Can you visualize being in someone else’s shoes?
• Who do you rely on for support? How long have you known these people and how do they support you?
• Describe your expectations for a child’s future needs.
• Describe your experience with children including in supervisory circumstances. Do you enjoy parenting activities? What gives you satisfaction and frustration?
• How will you develop your child’s self esteem?
• Outline your religious/spiritual situation.
• Describe the stability of your marriage and how you have managed difficult times.

All of these questions were overwhelming, but there were positives too. Rob and I were guided to have these conversations. While we’ve discussed much of this –

in some ways it renewed our excitement and commitment. It can be easy to get too focused on vacuuming and dusting, it is wonderful to know you and your spouse are on the same page.

The social worker had a month to write up her assessment and submit it to the agency. It was then that we were approved.

P.S. The homestudy social worker was a patient, welcoming, and encouraging — we enjoyed our conversation.

P.P.S. The baseboards will never be cleaned again.

Paperwork on Paperwork on Paperwork!

In the months prior to being listed with our agency, we were working hard on getting to our homestudy. A Homestudy is a required part of adoption in every state to protect children and make sure they are being placed in stable homes. The process also ensures prospective parents better appreciate all that is involved in adoption. Some people feel that the process is invasive, extensive, and overdone. I’ll give people that it is quite an endeavor; however, I can recognize that it is appropriate that the government and agency want to ensure that we are mentally, physically, and financially ready to parent a child. Many have commented that most parents don’t go through such background checks – and this is true. These parents are choosing themselves to create and have a baby. In our case, we are being given a gift by someone with unknown circumstances, and we owe it to those parents to be fully prepared.

After completing 9 hours of online continuing education and a full day seminar with our adoption agency we got this list of 29 tasks to complete in our off hours. There were lots of phone calls, scanning, and coordinating to accomplish this!

(1) Marriage Certificate. This one was easy, we have a bunch of copies.

(2) Divorce Decree. Not Applicable.

(3) Most Current Federal Tax Return.

(4) Financial Statement. Disclosing all of our expenses including utilities, rent/mortgage, loan payments, assets, debts, and life insurance.

(5) Current Credit Report.

(6) Letters From Employers. Basically, our clinical director had to verify we are employed full-time and, pending unforeseen circumstances, will continue to be employed. Thank goodness they said they want to keep us!

(7) Pay Stubs. Proof of our reported income.

(8) Utility Bills. Ensure we are up-to-date and again to review outgoing expenses.

(9) Personal References. Here we asked four friends to vouch for our character. Our great friends Lisa P, Kelly M, Laura H, & Sarah V all said they think we can do it!
(10 & 11) Federal and local background checks. This entails going down to the BMV, filling out some paperwork, and getting fingerprinted. Costs about $60 per person.

(12) Local Criminal Check. This involves calling our local police department to review our records and write a certified letter stating we have not been convicted or sentenced to any offenses.

(13) Certification of Residency. One of the requirements through our agency is that you have to live in Ohio for 5 years, so we had to produce documents (we used our tax returns) to show that we have been permanent Ohioans.

(14) Abstract of Driver’s Record from BMV. During our lovely morning at the BMV we also filled out some paperwork to have our driving records reviewed.

(15) Health Insurance Information.

(16) Medical Release. Signing permission for our agency to see our medical backgrounds.

(17) Medical Statements. We each had our annual physicals and then our physicians vouched that we have are in good health and able to provide care for an infant.

(18) Letter From Insurance Company. Prior to having a child, we needed proof from our insurance provider that they will cover an infant. Our insurance company seemed confused by this and it took two tries, but eventually sent a letter.

(19) Child Care Class. Rob and I registered for a class on learning to care for infants at Nationwide Children’s Hospital. Our instructor taught us about how babies look, communicate, and develop. We got to practice diapering, feeding, and bathing some very outdated infant dolls.

(20) CPR. Rob and I also took CPR certification class at Nationwide Children’s Hospital. This was quite helpful and we learned it is harder than it seems! I recommend everyone go and if you ever need an AED we’ve got you covered.

(21) Maternity/Paternity Leave. Here we signed a form where we agree to have one parent home for the first six weeks of the child’s life. This seems like a no-brainer, but many employers don’t offer any family coverage for adoption (maternity leave is for medical birth, that’s a whole story for another day) – and it can be a struggle to not be paid early on. We are agreeing to save money prior to having a child to be able to have one of us home to bond, support, and care for our new child.

(22) Acknowledgement Form. Signing we are aware of their fees and policies.

(23) Fire Inspection Report. I called the fire department and scheduled an inspection with our local force. One morning a fireman came and inspected our fire alarms, checked we have a carbon monoxide monitor and fire extinguisher, and checked something on the furnace (not even sure what he was looking for…). We also had to draw out our fire escape plans and this must be posted at every social work visit.

(24 + 25) Child Characteristics Forms. This is a blanket form used for fostering/adoption from newborn to adolescence. We had to say if we were accepting of a child in our home with a host of descriptions from personality (shy, tantrums), medical (orthopedic concerns, tumors), and psychosocial (family history of bipolar, borderline personality disorder). It is an extensive form with over 300 decisions that need to be made, with only ~1/3 of the questions applying to us with an infant. Quite humbling and thought provoking.

(26) Home Study Questions. A social worker came to our house for two visits totaling over 5 hours to interview Rob and myself. (Post to come!)

(27) Automobile Insurance. #MakeSureYouAreCovered

(28) Pet Records. I’m assuming to be a responsible parent, you should prove you can responsibly take care of your pet. We are proud to say our vet verified that Bingo makes his appointments, has his vaccinations, and takes his medicines.

(29) Emergency Contact Numbers. Never hurts to be prepared! We created a list of family members to be contacted in an emergency, as well as local agencies including the police and fire departments, physician numbers, and poison control. This is also required to be out whenever our social worker visits.

From the start of our paperwork to the end of the homestudy it took us about 3 months. Even though it was tedious at times, it also gave us something that we could control in this process and it felt so good to be taking active steps toward our family. It’s weird that not having any more tasks to complete has almost been more challenging. We’ve been trying to make up our own tasks to focus on (like purchasing things slowly over time) to help with the waiting game…

We Got A Car Seat

Car seat.

 We got a car seat.

 It sounds so simple, but the words repeat over and over in my head. Softly at first as I play with their cadence — we got a car seat. I practice saying it more confidently, clearly.

 We got a car seat.

 This car seat may seem like an obvious purchase to some. One of the many, many things I’m learning you need to have a baby. For us, a car seat is much more. It is the only thing you need to have when an agency calls to bring a baby home.

 This big piece of plastic, with complicated buttons and straps is the safety chair that we need to bring our baby home.

 And we have it. We are ready for a baby.

 The experience of buying a car seat began, as most things do in our house, with side by side lap tops. We pulled up tab after tab of options. Rob pouring over the consumer reports and safety feedback while I helped by finding the best looking in these categories.

 “Promise me you’ll look at more than just colors and fabrics…” – my husband begins his routine guidance in bringing me back to what is important.

 We enter Buy Buy Baby and I am an instant child walking into Disney World. Big eyes as I run from section to section: sweaters, blankets, cribs, diapers — I touch everything I pass trying to imagine the day I’ll actually buy all of these things.

 We finally enter the 10 rows of car seats and strollers, intimidated. We push one, then another. With each lap we pick up different personalities, trying to walk with sass, with caution, with confidence. There is a baby doll in the area and we practice placing it in different seats, each of us giving unsolicited advice.

 We both easily agree — the Chicco Viarra is the winner. After the sales lady nicely points out we are saying the brand name wrong (pronounced Kee – ko), we make our first purchase.

 We have a car seat.

 In the days that have passed I continue to say it to myself, turning it into a mantra that convinces me this will happen. We will be parents. While I’m generally optimistic and hopeful, at times it all seems so uncertain and full of questions.

 But we have a car seat. A step towards a family.

Adoption 101

I’ll never forget that moment. Rob and I went to brunch at a local favorite. We picked our football pool winners and talked about our week over salmon and egg breakfast sandwiches. As the plates cleared, we ordered a drink. I took a big breath and handed Rob a stack of articles.

I remember my heart pounding. I had read website after website, and was now about to share it with Rob. We hadn’t decided if this was the time to go forward with adoption yet, we wanted to look at the information. Yet as I had read and printed these pages my heart and brain had tumbled into the ADOPT NOW! Category.

I watched him read (he hates that). I’d try to look at different articles I’d printed, but kept stealing looks at his face. Kept blurting out my comments. Take a breath Nicole, give him a minute.

As he finished the last page he looked up and said “let’s do this. I want to begin our family right now.” That was a moment that brought tears to my eyes then, as it does now writing this. That’s when I feel our family really started to grow.

In the coming weeks we continued to seek out information to choose an agency that was the best fit for us. Here is what we learned from many phone calls, websites, and attending a day-seminar.

 

What Type of Adoption?

We chose to adopt an infant in Ohio.

 

How Soon Will You Match?

 So unclear! The agency estimates 18-24 months. Some families match within 1-2 months, many do wait 2 years. There are so many variables that we can’t ever know or control. Adoption can move more quickly if you choose to go with a national agency – but that also comes with more complications (explained below).

 

Boy or Girl?

Either! Some agencies at the national level allow you to pay for gender preferences, but most are neutral on the subject – and we are as well.

 

Will The Baby Look Like You?

Maybe! We only felt comfortable going with an agency that does not discriminate.

 

How Do You Get Listed?

A complicated process called a Homestudy (to be detailed in full at a later time). In summary, over 3 months we had two interviews by social work and full background checks that cover our medical, criminal, and financial histories. Tedious, yes. However, we are entering into a partnership with a parent who trusts us to do the most important thing – so I’ll let them inspect any part of my life that they wish.

 

Does It Cost?

Yes. Without being specific – I recommend anyone who is considering adoption through a private agency to begin saving money early. About half of the money is paid at listing, with the rest at the time of match to cover legal fees.

 

Will You Meet Your Child’s Biological Family?

Hopefully! Half of adoptions originate with an expectant parent picking out adoptive parents. Our agency would introduce us 2-3 months prior to expected birth date and we can form a relationship based on her comfort level. She can then decide if she is open to having us present at the birth.

Many children are also born while their parents are still finalizing their adoption plans. In this scenario, the agency would call to say a potential match has been identified and we would leave straight away to meet our (hopeful) future child!

At this time we have no idea which half we will fall in – but they are both so exciting.

 

How are Expectant Parents Supported?

Many agencies offer counseling and round-the-clock support. This is important. In addition, the State of Ohio allocates a portion of our agency fees to financially support mothers in their final months of pregnancy. Medical expenses are typically covered by insurance, but we would be responsible if this was not secured.

 

Will You Continue to Know Your Child’s Biological Parents?

 Oh I hope so! Our agency has an agreement that we will provide letters and pictures throughout our child’s life (once per month for the first year and then twice per year until the child is 18). Rob and I are very open to having the parents be much more involved if they would like to continue to visit in-person. Our family could grow in ways we never expected.

 

What If The Biological Family Changes Their Mind?

Then she/he parents! In Ohio, parents have 72 hours to legally make the decision to terminate their rights. We would return to the waiting game.

 

Will You Tell Me As Soon As You Hear?

Probably not! During those 72 hours our priority is making sure the child’s biological parents feel they have the space to think about their decision. We won’t be posting updates during that time to be as respectful as possible.

 

So Then Is The Baby Yours?

Sort of. Technically our agency will have custody, though the child will live with us. We will have social work visits 1 time per month for the next six months to ensure safest placement for the child. Then we get to be all dressed up and go down to the court house to make the Dempster Family official!

 

What If You Get Pregnant?

At our agency, we would go on “hold” which means we wouldn’t lose our money or time accrued on a waitlist, but our profile would not be available to show expected parents. This is to allow one to focus on each infant fully.

 

You  Have A Profile?

Yes, we made a 6 page pdf covering our backgrounds, daily lives, and future dreams for our family for any expectant parent to see. You can check it out here.

 

So Why Not Go For A National Agency?

While knowing you can expect a baby to join your family within a year is exciting and enticing, there are some important drawbacks.

– You will be traveling across the country at a moment’s notice.

– Parents stay in the traveled-to-state until t heir legal proceedings are met, and then have to wait until their home-state’s proceedings are met. This could take 1-3 weeks…much different than knowing we could be home in 3 days.

– It also costs much, much more to use a national agency. They have higher base-rates as well as the increased travel, lodging, and different state laws on supporting expectant parents.

 

My Friend’s Cousin’s Boyfriend Had A Bad Experience With Adoption

I’m sorry to hear that. Things do happen. There are good lawyers and bad lawyers, good doctors and not-so-great doctors. Ultimately, we are making the most informed decision we can for our family and moving forward.

 

Soooo….

that is the brief overview of adoption basics. We’ve received an outpouring of love and support – with other people sharing their journeys and their hopes to enter the adoption world one day. As always, please never hesitate to reach out personally, or to start a public conversation space here. We are stronger together.