Protein S

Six months. Twenty six weeks. Half a year since we said goodbye to baby Faith. I have dealt with so many emotions in that time. Not having a reason of death was maybe the hardest thing for me to accept. And so I blamed myself. I dealt with the guilt. I forgave myself. I vowed to do better next time.

Now, six months later, we have a probable cause of death: decreased Protein S activity. We tried running the lab in March, but the test wasn’t resulted. We tried again in June, but they didn’t draw that one among the slew of other ordered tests. Finally, last week, we got a result.

Protein S is a part of the inhibition of the clotting cascade. It is a vitamin K–dependent anticoagulant protein. It actually helps regulate how much your blood doesn’t clot. With decreased activity, you are more prone to clots. In the non-pregnant state this can lead to deep vein thrombosis. In pregnancy, “there may be an increased risk of fetal loss later in pregnancy, severe preeclampsia, abruptio placenta, and fetal growth restriction.” (Medscape) We experienced two out of four of these with Faith. She simply wasn’t getting enough nutrients to grow, likely due to a clot in the umbilical cord or placenta – somewhere along the line of transferring the nutrients that she needed.

I should be relieved to finally have some sort of explanation for her death, but it is taking me a bit to process. It forces me to rethink my role in our loss. Not only is it a probable cause for Faith’s demise, but it also puts me at increased risk for baby Skywalker’s pregnancy.

We had an ultrasound a couple weeks ago and he looked perfect. At 19 weeks, 2 days, he was measuring exactly 19+2. A relief. But the ultrasound before he was measuring 5 days ahead. Faith also was measuring ahead at an early ultrasound, then at her 18 week ultrasound she was showing low growth. It is so hard not to compare and speculate and worry. I try to remember,

 Matthew 6:25-27 ²⁵ “Therefore I tell you, do not worry about your life, what you will eat or drink; or about your body, what you will wear. Is not life more than food, and the body more than clothes? ²⁶ Look at the birds of the air; they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they? ²⁷ Can any one of you by worrying add a single hour to your life?

 While I haven’t seen the doctor in person since the diagnosis, we have spoken a couple of times over the phone. Treatment seems simple enough: low-dose aspirin and a shot of Lovanox (an anticoagulant) daily. I picked up that prescription today then went to the office to learn how to self-administer it. I’ll probably be on it through two months postpartum. I’ve never been afraid of needles, but the idea of giving myself a shot every day is taking some getting used to.

And then there’s the fact that while I’ve been seeing this high risk OB throughout my pregnancy, I haven’t really considered myself high risk. To me it was more a formality. Standard after a stillbirth with unknown reasons. Our baby would receive extra monitoring to check growth, but in my mind, it was never because of my own health. And now it is. Now I feel I have officially entered the realm of high risk pregnancy.

From midwife-assisted care for my first three, to high risk care for my fourth. What a difference. I am thankful that I am under this care. That we are testing everything this time, not leaving anything to chance. But even with the more medicalized care and more answers, we are not in control. I am not naïve. Anything can happen. But we continue to have hope for this new life. Feeling all of his little kicks and rolls helps a lot when I do start to worry. And I am reminded that my hope is in the Lord.

Psalm 62:5-8
⁵ Find rest, O my soul, in God alone;
my hope comes from him.
⁶ He alone is my rock and my salvation;
he is my fortress, I will not be shaken.
⁷ My salvation and my honor depend on God^[a];
he is my mighty rock, my refuge.
⁸ Trust in him at all times, O people;
pour out your hearts to him,
for God is our refuge.

The start of our Journey of Faith
The start of our Journey of Hope

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