Knowing (and Not)

The boys finally got their H1N1 vaccines today. I didn't want to deal with crazy lines, so we went through their pediatrician's office. Unfortunately, their pediatrician's office didn't get any of the mist, so I was forced to inform the boys that there would be needles involved.

I think we all still have traumatic memories of their five-year check-ups, at which they both received several immunizations and I discovered (too late) that when I had warned them there would be "shots," they had no idea what that meant.

But this time I figured we'd be prepared, so I gave them a heads up last weekend and have since been met with daily complaints, whines, and questions about why they have to do this. I informed them that sometimes you have to do things that you don't like to stay healthy. I went so far as to explain that while I was in the hospital pregnant with them, I had to get two shots every single day and that I didn't like it, but (and I swear this wasn't intended to be a guilt trip) "I did it because it helped keep you safe in my tummy." Seriously, I spoke those very words maybe two days ago.

So imagine how I felt today when I learned of this research, which says that beta 2 adrenergic agonist drugs might cause autism. More precisely: "Prenatal exposure to continuous high doses of beta 2 adrenergic agonists can permanently dysregulate signaling from the beta 2 adrenergic receptor."

Terbutaline, the drug that was injected into my body twice a day, every day, for 3 and a half weeks while I was pregnant, is one such beta 2 adrenergic agonist drug. Now, I don't usually jump at every article claiming such-and-such may cause autism, but it's not that often that the circumstances being described so closely match ours.

I'd say shock is the most appropriate way to describe how I felt when I read this. Then anger, then sadness. I've said over and over that I want to know why, but I guess I wasn't prepared for the possibility that something so avoidable could be the reason my little boy may face lifelong challenges.

And no, it's not concrete. I can't say with any certainty that this is what it was...that had I not been given those injections I would have two neurotypical children. If anything, I probably lean more in the direction that had I not had those injections, I might not have either of my kids today.

Terbutaline slows contractions almost instantly. Even combined with my IV of magnesium sulfate, it was never able to stop my contractions completely, but it definitely slowed them down and I do believe that slowing down my contractions allowed me to make it as far as I did with them. Had they been born when I was admitted to the hospital at 23 weeks, I don't think they would be alive. And if they were, we would likely be dealing with challenges far greater than high-functioning autism.

But...it's not as if I made an informed choice. I didn't know. Logically, I can't feel guilty about that, but there's something so sad about the idea that there was actually a moment when things could have been different.

Still, if we're talking risk versus reward, I wouldn't risk what I have. If I ever get my time machine, I won't go back to find out whether that drug made the difference between my babies living or dying on the off chance that had they survived, then maybe Owen wouldn't have autism. That's something I can live without knowing.

One More?

I dreamt I was pregnant again last night. It’s one of those dreams that pop up every now and then – usually when my husband lays his impossibly heavy arm across my stomach during the night.

As is usually the case, the dream pregnancy was a total shock and I therefore spent most of the dream counting how many beers and birth control pills I’d ingested in the preceding month…this is all laughable, of course, since it took us almost a year to get pregnant when we were actually trying.

Every mother, whether her child was born minutes or years ago, gets asked whether she’ll have more children. It’s a question that seems so innocent, but has come to seem intrusive to me…the way that it suggests that getting pregnant is such an easy task, that choosing to bring another person into the world is such a simple decision.

As anyone who has asked me the question in the last few years knows, my answer is a definitive “no.” However, I answer with such decisiveness out of practice more than some sense of knowing that our family is complete.

Before we had twins, we had always talked about having three kids (for the record, my husband was lobbying for seven). But after going through preterm labor, having tiny babies who spent their first three months of life in the hospital, surviving the exhaustion of raising two toddlers, and finding out that one of our precious boys has autism…well, two started to seem like a pretty good number. Not to mention that my husband has since declared us “done.”

If any medical professional could tell me that another pregnancy would even most likely result in another set of twins, end in preterm delivery, and/or produce another child with autism, I think I would feel more content with the decision not to have any more kids. I wouldn’t knowingly walk into any of those situations again.

But the doctors can’t really tell me anything definitively (including whether spending 3 ½ weeks on hospitalized bedrest actually made any difference). They just don’t know.

This all leaves me with lots of really good reasons not to have any more kids. And yet…I can’t help it, there’s a piece of me that still thinks about it. And it’s not that my boys aren’t enough, it’s just a feeling that there still might be room for one more. Maybe. Someday.

But then I think about the risks, about going back to sleepless nights, about potty training...and I feel sure again. “Nope, no more.” And so it stands. But if there’s one thing that becoming a mom has taught me, it’s never say never. And so I won't...just "probably not."