An epiphany

After reading many, many neuroscience studies (she has to edit them), a really good friend of mine told me she thinks she may have ADD (attention deficit disorder). She gave me a long list of symptoms, which made me go like, huh, I have a few of these issues myself: I zone out/am completely oblivious about the things that do not interest me, have a hyperfocus and a startling attention for detail for the things that do, and have major procrastination issues. Do I have ADD?? Probably not, given all the things on the list that I have to answer no to. But then again, to play the devil's advocate, maybe I do have a very mild form. One of the things I did not know how to answer: Do you have problems starting/finishing projects? I start/finish projects at work just fine (I managed to get myself a PhD, and that is the mother of all projects). But I am rather lazy outside of work. I don't do art. I don't volunteer. I don't cook/bake. I started vocal lessons and I abandoned them. Basically, I need to feel passionately about something to really work at it. Outside of work, the only place I have ever applied myself is in this area.

This morning, I woke up with a startling surety: I want to write a book on surrogacy in India. I never thought I would write anything other than scientific manuscripts, and this would be one heck of a project. After the birth, I had planned to write an in depth blogpost about what I have learnt, how you need to protect yourself when you get into this, and what needs to change for the betterment of the surrogates themselves, but what I have to say is so much more than what can go into a few blog entries.

Plus, if I really wanted to help people figure out the best way to proceed here, I would have to do so much more research, and the only way to work up to that level of commitment is to, well, commit myself to something big.

I think I am fairly well poised to be the person that provides a good accounting of this topic: I've gone through this firsthand, while living here, and the information you glean while going through this process is astounding. I've actually been to the hospital appointments and seen what happens. I have a clear idea about the financial side of things, and BOY, let me tell you, that stuff needs airing. The social aspects need airing. Surrogacy in India needs to be made more transparent, and change (through legislation) needs to happen, on many, many levels. I'd like to help that along, in whatever small way I can.

How DOES one go about this? I decided I would not do this half-assed. I would try to find an agent and a publisher, and then proceed. The first step involves putting together a book proposal. Then, I can go agent hunting. Ulp.

I hope this is a project that is not a one-day/month wonder for me, and will end up making a bloody strong case for me *not* having ADD. 

Checking in: 29 weeks

Random things in bullet points:

• My OB did get back to me after I finished my last post, saying that the surrogate DID need to be given the anti-D shot. Her assistant had not put that on the report. I then had to get the prescription ordered and get the surrogate to Dr. Bhansal who agreed to give the shot, and I reluctantly decided to get the ultrasound done too, because we were going there anyway. As I was on my way there (with slight trepidation in my silly heart as I was going alone for the first time to an ultrasound), my mom called and told me she had missed her flight and could make it there anyway. YAY. Thank you Universe.

•  I got proof that fetal biometry readings should be taken with a giant pinch of salt: Remember a while ago that I was mildly nervous that the head circumference (HC) was in the 12th percentile? This time, it was around the 50th percentile, while abdominal circumference (AC), which was around the 50th percentile the last time around, had now fallen to the 7th percentile. The only thing that has been consistent is the femur length, which is around the 80th percentile in each scan. So yeah, fetal biometry, not seeming hot, really.

• I also met a lawyer to take care of the legal stuff for getting the baby back to the States. Her first question was, where did you do your IVF treatment? She asked me this because there are apparently some doctors in Delhi who have put other people's embryos in a surrogate, and the poor parents have a bone jarring shock after birth when the DNA test revealed that the baby was not theirs. If you are a foreign national who planned to return to your home country with your baby, things get impossible, and there are families in limbo and babies in limbo because of this. Horrifying. She did tell me that she had handled some surrogacy cases coming out of the Malpani clinic, and they had been ethical and did not pull such horrifying cons. It is unbelievable that there would be doctors out there who would do stuff like this.

• The baby is just past 29 weeks now, and should hopefully approaching 3 pounds soon. Still so utterly tiny. Nearly every day, I google fetal survival and fetal weight and go over information I should be able to recite in my sleep by now. Previously, 28 weeks was my safety mark. Now, it is 34 weeks, where the only issue a baby may have may be an initial inability to suckle. It is also getting more real now: I've been my own person my entire life. It is terrifying and exciting that I may be getting a little person who will take over completely. 

• I told my aunt (who I am pretty close to) the news. The last time I told a family member I was trying this, their reaction was so ugly that I was badly burned and decided not to tell anybody in the family till the baby was here. In contrast, my aunt's reaction was wonderful. She just kept repeating that she was happy for me that I am getting a child of my own, but so sad that I had gone through 3 miscarriages and such a difficult journey by myself, and that she was just so glad that my parents had been there for me and had known all along. It was a lovely, lovely response, and I am so lucky to have her in my life.  

More glimpses of the realities of surrogacy in India

J goes to Hiranandani hospital for her routine OB-GYN checkups. I went with her for her very first checkup, and it was an intensely disconcerting experience. There are about maybe 12 surrogates gathering and waiting for anywhere between 1-3 hours. The OB-GYN's assistant shows up, and starts seeing this procession of women. They get a doppler check and their blood pressure and weight read, all while the next 3 patients are queuing up on the other side of the curtain while the first patient is in the bed. My mom likened it to the situation in the poorest, most strapped municipal hospitals, where she worked briefly as an intern

After that first painful experience where I waited over 3 hours for a 15-min cursory check complete with an ancient-looking doppler, I never went again, and instead only go with J to the wonderful, detailed ultrasounds that are run at the Mediscan testing center by the very capable Dr. Bhansal.

This past Wednesday marked 28 weeks, and J went for her checkup at Hiranandani. I contemplated going, but I decided to just trust the system and sent her off with all the reports and expected her to get both the Rhogam shot and much discussed mandatory steroid shot. Too many times where I decide to just trust the system here, it has turned out to be a Bad Idea. But that is a topic for another post.

I talked to J after the appointment and find that no injections were given. I then try to find out what happened. If you go to an agency like Surrogacy India, they have this system where all the reports are scanned and uploaded and are available online for the parents immediately. Here, with the Malpani Clinic, there is no such centralization. I've spent 3 days waiting to find out what exactly was done at that visit. The surrogate handler claims that she gave the report to the receptionist at the clinic, who then claims to have emailed it to me. No such email was received. The handler claims she reminded the receptionist of it again one day later, and that she apparently mailed me. No mail was received. I've asked the doctor what was happening, and have received no word. I am SO very glad that I have to deal with this system only for another 10 or so weeks.

But here is the deal: they don't give the steroid injection at the hospital, they only write the prescription for it, and expect that some local nurse or some local doctor will give it. In the case of the Malpani clinic, the person who gives the shots is no trained nurse, but the handler herself.  A little background on the handler: This is a woman who has gone through surrogacy herself, comes from the same socio-economic class as the surrogate, and is partially literate, but at best studied till high school. In general, these are not people who are professional and impartial: they may not above lying for the surrogate (remember the story I posted about the handler who helped a 42 year old surrogate propagate a lie that she was 28?). 

In this case, the handler will give the shot at her home.I have to pray that the she is atleast trained in sterile techniques. I asked my RE about this, but as with most situations, I got resounding silence.

Here is the other thing: J told me that Dr. Malpani thinks that the Rhogam shot at 28 weeks is not necessary. He has not bothered communicating this directly with me, and nor has the OB-Gyn.

The person who did seem to think it necessary is Dr. Bhansal. She is a fetal metal specialist who works with high-risk pregnancies. She is also the go-to person for detecting fetal anemia, and is also the go-to person to give transfusions in the situations where it does develop. I'll have to talk to her about the necessity of this again. I totally hear you guys about the many places that do not give this prophylactically at 28 weeks. The one reason why I'd be more concerned here is because this is a surrogacy, and J may not be as prompt as required if something goes wrong (if she falls, etc).

But, in happier news, we have crossed the 28-week mark. This is the point after which the complication rate falls considerably. I was supposed to go in for an ultrasound tomorrow, but my mother will not be in town. A while ago, my friend M told me to always take my mother with me to the ultrasounds, because she is my lucky charm. I take that advice very seriously: she has come for every appointment, and I'm far too chicken to go in without her now. The next ultrasound should happen in the middle of next week.  

Also, I want to celebrate the surprise (to me anyway, I had NO idea) pregnancies of 2 bloggers who are very close to my heart, who have stopped actively blogging. I think it is rather cool that two such very wise women who I thought were actually quite similar (in their outlook on things and their utter sensibility)  are so synchronized with their pregnancies; they both just crossed 24 weeks. Adele and Arohanui, so very happy for the both of you!