To Noah in utero

I wrote this letter to Noah on Wednesday, November 3 2004. That night after I went to bed my water broke and Noah was born 15 days early.

Noah,

You're almost here, and we are SO thrilled. Our lives are going to change radically the moment you enter this world and we couldn't be more ready. We're a little nervous too , but I believe that often the most worthwhile decisions in life are also the scariest to make.

This is my first letter to you and I hope to keep up with these occasionally though out the course of your life so you’ll always have reminders of your past and of how much you were loved and thought of.

Your Dad and I knew from early on that we wanted to have a family some day. As we were both raised alone as only children from broken homes, we both envisioned having a large loving and affectionate family with two parents and several children who really enjoy being together, even when they're driving each other a bit crazy (as family does).

So in July of 2003 we planned a trip to Paris over my 29th birthday as our last childless hurrah before we settled in and planned to have a baby. I foolishly thought it would be only a month or two before you were on your way. Though my doctor reassured me many times that it could take a healthy fertile couple an entire year to conceive naturally, every month that passed without me getting pregnant made me more convinced that we weren't going to be able to have a baby. After several months of charting my cycle and disappointing outcomes, on March 11th I found out I was finally pregnant. The funny thing was that I had done a pregnancy test a few days earlier and it came back negative. But when I still hadn't gotten my period after a few more days I decided to take another one on a whim. Your Dad was already at work when I got a positive result. I went to work beaming and from my cubicle I called your Dad. "I have a HUGE surprise for you. Guess what it could be?" I said. And your Dad cautiously said he didn't know. I said "It's what you’re afraid to guess" and instantly he knew. We were both SO excited. We met for a long lunch at an Italian restaurant across the street from his office to celebrate.

In terms of my early pregnancy, I was really blessed with few symptoms. I would get a bit nauseated if I wasn't eating constantly, but I had no serious morning sickness. I had cravings for almost everything – and I developed a sweet tooth like I had never known before. I could eat chocolate constantly and could not pass up a single dessert. I had a couple of weeks where I wanted to eat nothing but large bowls of carbs - buttered noodles, rice, macaroni & cheese or mashed potatoes. I was going to prenatal yoga the first couple of months and generally felt really good. Unfortunately the acid reflux I've always had soon caught up with me and it was even worse than usual. I had to start avoiding yoga because bending brought acid into my esophagus. I just dealt with it until I reached my third trimester when one of my doctors's put me back on reflux meds. By then I was too big to bend.

We were really concerned about you for a couple of months during the pregnancy. At week 18, June 18th, we had our first ultrasound. At the actual visit the sonographer didn’t mention any concerns. In fact we were SO pleased that you looked well and that the photo really did look like a baby and not an undecipherable blob. But the following week Dr. Murthy asked me at my regular OB appt if the sonographer had mentioned the bright spot they had seen in your heart during the ultrasound. She told me many times that it was nothing to worry about but that they had seen a small bright spot in your heart and on the very slim chance that it was a signifier of a chromosomal disorder that they would want to do a follow-up ultrasound. She told me there was no rush to have the second ultrasound as it was merely a precaution and she wasn't concerned. But once I got home and we did some research on the Internet, your father and I discovered the bright spot or "echogenic focus" they saw in your heart could be a signpost for Downs Syndrome. We were on edge for two weeks until our next ultrasound, but we decided not to share the information with anyone else because it seemed unnecessary to alarm everyone. Our second ultrasound was on Friday afternoon, July 9th. We had hoped they would no longer see the focus or merely rule it out as insignificant and that would be the end of it, but at that ultrasound they saw an "echogenic bowel" meaning that your little bowel was showing up bright on the ultrasound. This was a second signpost for Downs Syndrome. Unfortunately the Genetic Counselor had gone home for the day and we couldn't see her until Monday morning. So we cried and worried for your health all weekend - looking up all sorts of things on the Internet. We soon realized from the doctor's comments and our research that what they had seen on the ultrasounds were not clear signs that you would have Downs Syndrome - but they were two among almost twenty things that they sometimes can see in Downs Syndrome babies in utero - however individually they were also found in normal children. Detecting them in your ultrasound just increased the possibility that you might have Downs Syndrome and therefore to rule it out the doctors were suggesting we get an amniocentesis - which was the only clear-cut way to be sure either way. Your Dad and I talked about it a lot and because an amnio holds a risk for miscarriage, and because finding out if you had Downs Syndrome would not effect our decision to keep you - I felt really strongly that it was not necessary to have the amnio. My mom was so worried about everything that she decided to come to the counseling session on Monday. On Monday we met with the counselor and after discussing the mathematical possibilities of you having Downs Syndrome and our feeling that we would have you regardless- we decided against the amnio. We decided to just stay positive and try to progress with the pregnancy as normal. I decided I didn't want to tell many people about the ultrasound scare because I didn't want there to be a negative shadow on the pregnancy - but I eventually told a small handful of people because I'm not good at keeping anything in. At week 28 and week 36 we had follow up ultrasounds because the doctors were still considering you a high risk birth - but both of them saw no negative signs - in fact both the bowel and heart cleared up. And though as your father said "Whatever you have in there is ours and we will love him regardless," we are very hopeful that you will make your entrance into this world with your health.

It seemed to take forever to come up with your name. If you were a girl we had quickly decided that your name would be Muriel - after your late grandmother. But we were having big problems with boy names. We wanted something old and traditional but not something too common or too odd. We would add names to a list and then remove them. We would feel almost decided on something and then suddenly decide we didn't like it. Noah was the only one that stood the test of time and when we told people we were thinking of Noah, there was almost always a positive reaction. Of course we considered that you'd be overwhelmed with references to the arc and Noah Wylie of ER - but decided the name was a good one and the right one.

By September I was already HUGE. And I was getting more and more anxious for you to come out. The first week of September your Dad's best friend Ed came to help paint the nursery. Your first room was sunlight yellow, lime, and poolside blue. I wanted to give you bright vibrant colors and not boring pastels. Of course our friend Tracey instantly told me it was too bright, you'd never sleep, and that you'd have to constantly wear sunscreen.

It was really a blessing for me to share my pregnancy with my best friend Patrice. It's nice to have another pregnant lady to complain to about pains and mood swings and to daydream and plan with. You will always be just a little younger than Bella Milligan, and I hope you are lifelong friends too.

Patrice helped Grandmom Carol plan your baby shower. Grandmom totally outdid herself and held a really nice party at an Italian restaurant in King of Prussia. The food was great and there was so much love and excitement about your impending birth. There were 32 people there total - lots of friends and family. You got so many cute outfits and little toys. We could barely fit everything in our car. And with all the stuff Grandmom has been buying since the day she found out I was pregnant it's clear you'll want for nothing. Grandmom really is overwhelmingly excited and helpful. She's constantlyshopping and planning. It's obvious you're going to be one indulged little grandson. She had a nursery set up at her house before we had ours set up. Your Dad and I make jokes that it’s clear that we’re giving birth to her baby and we hope she lets us see you.

In the last few weeks we took classes in everything Pennsylvania Hospital offered. We took Child birthing, Breastfeeding, Baby Care Basics and Infant CPR. Though I had some experience with babies when I was younger, your father has never even changed a diaper. But he is so excited. It really just makes my heart melt to see how thrilled he is to see a baby on the subway or hear a little boy talk to his parents. He is so excited to be a Dad and it makes me tear up to think about how much he already loves you. Even without one day of real practice, I know you have a fantastic father.

On the morning of November 2nd, not only did we think we might end the day with a new president, but also with you. At my 37-week checkup my doctor was concerned that my increased blood pressure and some protein in my urine sample meant that I was developing pre-eclampsia which would put both you and I in danger. So she sent me to the hospital for more monitoring with the off chance that if I did have pre-eclampsia that they would induce labor. My blood pressure went down while monitored and I was scheduled for a follow-up doctors visit on November 2nd - with the knowledge that if my results pointed to pre-eclampsia that they’d induce that day. After going to the polls to vote for John Kerry your Dad and I went to the doctor's office with our hospital bags packed, totally convinced that it could be your day. Happily my test results were good - and they aren't concerned you're suffering any ill effects due to my blood pressure so they decided to let you hang out in there. But it was a bit disappointing to come home afterwards with our bags still packed and without you. In the next couple of weeks up until your due date we might have several doctor visits like this.

I'm home on rest now and I'm eagerly anticipating your arrival. And though I am a bit scared of childbirth, I can't wait to hold you in my arms and to have you join us. Your father and I have so much love, for each other and for you, and I really do feel that will make us good parents. We'll definitely screw-up occasionally because we'll be making things up as we go along (after much research) - but I think our intentions for you to have a wonderful life filled with love, wonder, and promise will outweigh our blunders.

I hope when you read this stuff when you’re older you are able to nod your head and think we did what we set out to do. That you felt loved and cherished not only as an individual but also as part of a close-knit family.

Noah, we can't wait to meet you. I plan to write you again after you've been born - so that you can hear all about the day of your birth. All the gorey, bloody details.

With so much love,
Your mom