Monday, May 8, 2023

The Rate-Determining Step

I am not sure if it has come up here before (probably so since I have written about all kinds of things over the years), but there was a significant portion of my life when I wanted to be a medical doctor. Life, my science grades, and my test scores took me in a different direction, and I never tried to retake the MCAT or reapply to medical school. But before all of that, I still learned quite a bit of chemistry. For some reason, I recently remembered the term "rate-determining step," which in the chemistry world refers to the slowest step of a chemical reaction. This step (often?) determines how quickly the rest of the reaction can proceed. My general chemistry professor, Dr. Dopke, explained it something like this: if we decided we wanted to go to the beach in Florida (leaving from Mercer's Macon campus in central Georgia), there would be a few steps involved. We'd need to (1) head back to our rooms/homes, (2) pack our bags, (3) load up the car (and maybe get gas), and (4) actually drive to the beach. Some people lived closer to the Willet Science Center than others, so the duration of step 1 would vary a bit. Similarly, some people pack deliberately, and others throw a few things in a bag and head out. Even with those differences, what would really impact the travel time would be step 4: getting from central Georgia to some coastal area in Florida.

Lately, I have been thinking about how much I shared as we navigated fertility treatments and how quiet I have been through pregnancy (comparatively). Medically, I have been fortunate to have an uncomplicated pregnancy, but I remained guarded because I had gotten my hopes up so many times when we were trying to make embryos and stay pregnant. I also remembered how hard it was to see what felt like the rest of the world moving forward with growing their families while no amount of hoping, praying, or throwing money at the problem seemed to work. While any updates I posted about my pregnancy were met with support and enthusiasm, I didn't want to trigger other people who were still in the infertility trenches. The days kept ticking by, though, and every week was a little better. Then when I reached 32 weeks back in March, my doctor started bringing me in for twice-weekly ultrasounds (thank you, hypothyroidism and pregnancy!) and told me we would schedule an induction for the baby. That initiated a whole new series of worries that maybe there was more wrong with me than I realized. Eventually, I grew to welcome the little visits to see how the baby was progressing--largely because everything looked good at each visit. 

Going back to the chemistry analogy, pregnancy has, in many ways, been the rate-determining step in our journey to grow our family. Cumulatively, the nearly three years we spent trying to conceive were longer in duration than this pregnancy, but there was a conclusion at the end of each month; not pregnant, try again. Each IVF cycle had its own mini-steps where I could provide updates: follicle measurements, retrieval numbers, fertilization numbers, blastocyst numbers, and testing results. Our first two embryo transfers led to short-lived pregnancies, so I always had an update about those as well. With this pregnancy, however, each appointment or update was the same: still pregnant, probably going to have a baby, but no guarantees that some unusual circumstance could strike.

We scheduled the induction for today, and I am writing this post with an IV in my arm. I am getting fluids and medication through the IV, and the contractions are starting but are mild. At my ultrasound on Thursday (May 4), Baby Davis's estimated weight was 9 pounds, 10 ounces. My doctor reported that the baby was still sitting up high, and my cervix was closed. Like for real closed. It turns out this baby is smart like their parents and figured out that life on the inside is pretty sweet. We discussed a possible C-section instead of induction, but I told him I would like to try labor and see if I could deliver vaginally. So, that's where we are at the moment. Ultimately, our goals are (1) a healthy mom and (2) a healthy baby.

After I was all hooked up this morning, our nurse told me she would be watching the baby for any changes while I rested. We have been listening to the baby's heartbeat on the monitors. Before I drifted off for a short nap, I told Richard that I was glad to be in the hospital so if anything did turn south, we would have a team ready to take the baby out and give us both the care we need so we can achieve our two goals. I am surprised at how reassured I am by the sound of this little heartbeat, and I can't wait for the end of our rate-determining step as we proceed into parenthood.

Until that happens, we continue to welcome thoughts, prayers, gender guesses, and funny labor stories. I'm going to take another nap.