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Pregnancy post-heart transplant and First Trimester Recap

First off, I want to say that I know TTC is a journey and not an easy one for many. If you’re not in the place to read about pregnancy, please feel free to skip this post or unfollow. Do what’s best for you, your mental health, and your heart. 

Below I answer a few questions I’ve received via Instagram. As you all know if you’ve followed me for a while, I’m an open book. I know my experience is somewhat unique, but I also know there are so many young women with organ transplants out there who long to have children of their own. If you have additional questions, you can also reach out on IG and I’m happy to share my experience and answer what I can.

How did your team feel when you told them you wanted to carry?
I first brought it up in 2018 when Steven and I were about to get married. I wanted to ease into the conversation, but also wanted plenty of time to do my own research. When I seriously brought up getting pregnant and carrying a child with my team, I could tell they were not thrilled with the idea. They offered other options such as surrogacy or adoption, but in the end, they told me they could not tell me no. They wanted to make sure I understood all of the risks before trying. They did share my heart was healthy and there were no concerns from them with carrying a child. I joined the Pregnancy & Motherhood + Organ Transplant group on Facebook to learn more about others’ experiences and read a study done by the Transplant Pregnancy Registry, I wanted to make sure I did all my own research to fully understand the pros and cons before moving forward. 

After meeting with my team and doing a lot of research, Steven and I talked and were on the same page. We both agreed I was given this gift of a second chance for a reason and I needed to live it to my fullest. 

When did you feel ready to start trying after transplant?
Since I was 14 when I received my transplant, I had plenty of time to feel ready and prepare. Personally, I don’t think we would ever “feel ready” to have a child, but after being married for two years, feeling secure in our jobs and since my health has been very stable, we decided to start trying. 

Did you plan your pregnancy?
Technically yes, but it still came as a surprise. We had approval from my transplant team and GI before starting to try. After a year, we met with a Reproductive Endocrinologist, which ended up being a terrible experience. After we met with the RE and met with my transplant team (to discuss if they were comfortable with us receiving help from an RE if needed), we got pregnant on our own a little over a year of planning/trying. 

Have you needed to adjust any of your anti-rejection or other medications? Do your transplant medications have to be monitored more frequently?
I was not on any immunosuppressants that prevented me from being able to get pregnant. I was on some additional medications (for transplant), that I’ve had to go off, such as pravastatin. 

I have had to change my Prograf dosage due to my levels being low. I’m having my bloodwork done monthly to monitor my levels and we’ll change my dosage if needed. My team is definitely doing a great job monitoring me and staying on top of my levels. 

Do you have any special limitations during pregnancy due to transplant?
Surprisingly, no! I don’t have any additional limitations, just the normal pregnancy limitations. A lot of the food-related limitations (no raw fish, etc) I already followed due to transplant, so I haven’t had to make any major changes. 

Are you being monitored more closely by your team?
Yes! I am currently seeing my transplant team monthly, with an echo and bloodwork at each appointment. I am seeing a Maternal-Fetal Medicine (MFM) team every 3 weeks who keep an eye on baby and my health. I’ve only had two MFM appointments so far, but I love love love the team. 

Before trying, I knew I’d need to see an MFM once pregnant. I spoke with a fellow heart transplant mama, and she highly recommended her team at Texas Children’s Pavilion for Women – so that’s who I decided to see. I’m so glad I did. They’ve done an amazing job making us feel welcome and involving Steven in the conversations which we both appreciate. 

Are you able to carry full term? Breastfeed?
I assumed I’d be induced early (and would most likely have to have a c-section) and that I might not be able to breastfeed due to my medications. I brought this up with my MFM team during my first appointment. They let me know that as long as everything goes smoothly, I can carry to full term and I can deliver naturally. 

As for breastfeeding, I can breastfeed but might have to space out feedings from my medications. This is a longer conversation I need to have with my team, but I’m glad I have the choice. 

Are you going to find out the sex of the baby?
We actually already know! Steven and I have decided to keep the gender off social media until Baby K is born. Finding out the gender definitely made it feel more real. I’ve already planned out most of the nursery and can’t wait to get started decorating. 

How did you tell Steven? Parents?
Due to the pandemic, Steven and I  have been sitting next to each other in the office for months. On the day I found out, he’d left the house to go run an errand for work. I have zero chill, so Steven knew right when he walked in the door. I was holding back tears, but months ago I’d bought a fake scratch-off ticket that when you scratch it, it shows 3 pacifiers and the prize says “We’re having a baby!” I was literally crying and was like “I got you a scratch-off.” I’m thankful he went along with it, scratched it, and then turned and hugged me. I think we were both In complete shock.

We told Steven’s parents the week before Christmas, at right around 5 weeks. I ordered ornaments from Etsy that said “Baby K, August 2021” and the box it came In said, “Your real present is arriving late.” Telling them was so much fun and we all celebrated. The next day, we woke up early and drove to Austin to tell my parents. I felt very strongly about telling them in person. I’d worked with one of my mom’s friends to make sure they’d be home when we just showed up. So we rang the doorbell and my dad answers and goes “What are you doing here?!” My mom was in her pajamas and absolutely caught off guard. We told them that we missed them and wanted to deliver our Christmas gifts In person. We sat on the back porch and my mom went to open the ornament and read the box out loud – my dad looked at me and goes “Are you expecting?!” I nodded my head yes and my mom didn’t hear what my dad had asked. She read the ornament and freaked out. It was so great to finally have our parents know the exciting news we’d been keeping. 

How was the first trimester? Anything you wish you’d known? (TW: mention of bleeding in the last paragraph of this answer) 
The first trimester was…rough. Not only physically, but mentally. It was much harder than I expected. I think the fact that I’m very open with friends and family about how I’m feeling and in general, made it really hard to keep the pregnancy a secret. When I’d text friends and they’d ask how I was doing, it was really hard to fake that I was fine. One of my best friends told me she was pregnant, and I decided to share with her. She’s about 7 weeks ahead of me, and having her to lean on was (and continues to be) a lifesaver! I finally started telling other close friends at 9 weeks because it becoming a lot for me to hide. 

Physically, I did not feel prepared for the morning sickness and nausea. My mom didn’t experience It and most my friends didn’t, so I really thought It wouldn’t be that bad. I was very wrong. While my morning sickness wasn’t the worst, the nausea was unreal most days. I could barely eat and just wanted to sleep. Weeks 6 through 9 were the worst and I was thankful when my appetite returned to normal. 

I also experienced bleeding twice during my first trimester. The fear and anxiety that comes along with that was terrible. I’d spiral into thinking the worst and let my anxiety get the best of me. Both times, baby was fine and doctors couldn’t explain why It happened. Before getting pregnant, all you learn is that “bleeding is bad” but it turns out, a lot of women have bleeding in their first trimester for a multitude of different reasons. I wish I’d known that and had been more prepared for it. While it doesn’t happen to everyone, just knowing It’s a possibility and everything can be fine, would have helped my anxiety a ton. 

How are you feeling now?
Finally, I’m feeling like a human again! I’ve started working out and I’m able to help around the house again. It’s so nice actually having an appetite and wanting to eat food. My bump has also started to pop, which is really exciting!! I always hear the second trimester is the best, so I’m trying to soak it up.

We’re doing some house projects before getting started on the nursery, so we’ve started on those. I’ve also been selling a lot of furniture and trying to cleanout the office a bit. I feel like I get more and more excited each day. August seems SO far away, but at the same time, It feels like it’ll be here before we know it. 

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