Anjali Mulari

Our Fertility Journey.

Anjali Mulari — Wed, 08 Jul 2020 08:58:30 +0000

I want to start by saying that my heart goes out to everyone who has, or is struggling with fertility, however long your journey may be. In hindsight, my journey wasn’t very long but when I was in it, it felt like an eternity.

I always knew I wanted children. I had surgery for endometriosis when I was 18 and it was classed as moderate to severe. I remember my doctor saying that when the time comes I might struggle to have kids. I didn’t think much of it at the time.

Fast forward six years to 2017. I had been selected for the Ice Fernz to compete at the IIHF Women’s World Ice Hockey Championship Div IIB in Spain in March 2018. I was hoping that would be my last tournament before getting pregnant. In my mind it definitely wasn’t the end of international ice hockey for me, just a short break.

In December 2017, my doctor removed my Mirena (IUD). She is a gynaecologist who also works at the fertility clinic. She said if we were unsuccessful after six months to go back and see her.

Setti and I got married in February 2018 prior to the World Championship in Spain. Did we start baby making on our wedding day? Noooo, I passed out and Setti went and partied with our friends at another venue LOL. Anyway, the plan was to start after the tournament in Spain.

I had an app on my phone that told me when I was fertile based on the data I entered into it. I used the Glow Fertility App. I would follow this and each month I would be hopeful that this was our lucky month. Six months came around and we were still unsuccessful in getting pregnant. I contacted my gynaecologist and we made an appointment at the fertility clinic. We had the checks done and Setti was fine – thankfully. My Anti-Müllerian Hormone (AMH) level was on the lower end of normal for my age, bordering on the orange zone. The AMH test is a reasonably easy way to estimate your ovarian reserve. It is performed by a simple blood test. My doctor said we will likely need to undergo IVF to get pregnant. Once we had been trying for 12 months, we could go onto the waiting list for a publicly funded round of treatment. Thankfully we were eligible for public funding because of my endometriosis. The waiting list at the time was 12-18 months. Wow. In my head I was thinking I was so ready now. This was devastating. For anyone that knows me, you would know that I’m quite impatient.

At the time, one round of IVF in New Zealand was approximately NZD $14,000. This didn’t include all of the tests we had already had to find out the reasons why we may be struggling to get pregnant. It is a lot of money, especially when you know the success rate is about 50%, if that. I did some research and found out my health insurance through my work could give us $10,000. It was one of the only health insurance providers to offer this. I looked into it and Setti had to be on the plan for 12 months before we became eligible. I signed him up straight away. This meant we could go for our first round in September 2019. This was still one year away and I didn’t want to wait. Setti was a bit more patient, even though he was pushing 40 🤪.

While we were going through this process we were still trying each month. It’s not easy. There were a lot of tears. I would check the app on my phone many times a day to check when I was next fertile. After the fertile period there is the incredibly awful one-two week wait where you’re praying and hoping with all of your body that this would be it. We would go out and I would be hesitant to have a drink – maybe I was pregnant? The thought is constantly playing on your mind. You try to spot symptoms. This feels different – maybe I’ll just give it a Google. Ahhh Google. My worst enemy but also my best friend. You find forum after forum of people feeling your anxiety and tension. It’s a funny thing – you get scrolling hoping to find something or someone that sums up how you’re feeling and what you’re experiencing. If you do, you hold onto it. You think OK, they experienced this and they got pregnant so maybe this is my month too? Then you’d see the opposite. They didn’t get pregnant this month with that symptom. So then you ignore it and pretend you never read it. You believe what you want to and it’s a dangerous place to be.

I would use ovulation strips each month that look for the level of the luteinizing hormone (LH) in your urine. Much like a pregnancy test, you look at the second line. Although, instead of just looking for a second line, you’re looking at how dark the second line is. You want it to be as dark as the control, if not darker. It’s a bit hit and miss with the interpretation but it’s better than nothing. This next bit is gross, soz. I would also use the appearance of my “vaginal secretions” to help with predicting ovulation. It changes in consistency when you hit peak ovulation. If you’re trying to get pregnant – look it up but don’t click on Google Images 🤢

While all of this was going on, expressions of interest opened for the 2019 New Zealand Ice Fernz. The team would be heading to Romania in early March 2019 to compete at the World Championship. I was very unsure about what to do. Do I put my name forward? What if we get pregnant? I made an effort to be open and honest with the coaching and selection staff so they knew our situation. I ended up making the team and training for the tournament. I thought why wait around for something that may not happen anytime soon… That didn’t stop me thinking about it most minutes of every day.

We were seriously contemplating paying for the first round of IVF in about January 2019. This was prior to the tournament. After many conversations with Setti and my family we decided to wait until after the tournament for IVF. I was so impatient that I wanted to try something different in the meantime. I looked into different drugs you can take to boost ovulation and I asked our gynaecologist about Letrozole. She said it might not be useful for me but said there was no major harm in trying. It is normally used for women who don’t ovulate or have irregular cycles. I didn’t really fall into these categories but I took the drug anyway. If I can remember correctly, one monitored cycle of Letrozole was approximately NZD $300-400.

On days three to seven of my period I took a little pill. A few days prior to ovulation the clinic would do an internal scan to observe the growth of the follicles. We tried it for the first time at the end of 2018. I had two follicles growing well and the doctor said “have intercourse for the next five days”. It’s a bit weird when someone else is telling you to have sex but we followed their instructions and did the deed everyday over the important days. That round didn’t work and it was quite disheartening. I was hoping now that we were doing something new that it would work straight away.

In January 2019 I had five more little Letrozole pills. We decided we may as well pay for one more round and use up the last of the pills. The internal scan came around and I had one follicle growing nicely. Once again – “have intercourse for the next five days”. We followed the doctors orders and tried to enjoy it ha. It is a bit weird when there is a purpose to the deed and it is playing on your mind. I remember having hockey this month and attending two weddings. I was no less anxious than any other month and it was definitely still on my mind everyday. I wanted this so bad. I’ll never forget the words of wisdom from people trying to be nice by saying “try to not stress, it’ll happen.” HOW DO YOU NOT STRESS? I know people are trying to be kind and considerate but I seriously couldn’t figure out how to relax when it is so frustrating and you want it more than anything in this world. I think my best advice to people is to keep busy. The more things I had on, the less time I spent on Google going crazy 🤪

Four days before my period was due I took a pregnancy test at my best friend’s house. I did not feel any different. I was just being impatient me and testing as soon as I possibly could. I watched the pee move along the test and I could see an extremely faint second line. WAS THIS IT?! I couldn’t believe it. I yelled to my friend to come and look. She said, “what does a second line mean?” – my eyes almost rolled out of my head. She insisted I do another test. Once again, a second line, although very faint, it was there.

I phoned Setti and of course he didn’t answer. When I finally got through I repeated the words I had been longing to say, “Babe, I think I’m pregnant.” He paused and I think he teared up. Bless. As you can imagine we were both feeling over the moon. I was excited but also nervous. I wasn’t sure it was real and I wanted to wait for a blood test to confirm it before I got too excited.

Once it was confirmed I remember speaking to the fertility clinic about what comes next. She said we had “graduated” from their clinic and we need to go and find a midwife. I’ve graduated twice before but that was my favourite graduation by a country mile.

My Birth Story.

Anjali Mulari — Sat, 25 Apr 2020 12:04:24 +0000

I had heard the stories about birth… mostly about the pain. People tell you these things and you think you are prepared.

I was so eager for the moment I had any sign of labour; I was actually quite excited. Of course, I didn’t know how it was going to go, no one does. In my head I had pictured every imaginable scenario. Setti (my husband) works in Auckland so I was more than prepared to make the phone call, “Babe, it’s happening”. Luckily it started on a Saturday and Setti was by my side throughout the whole process.

I had experienced reduced fetal movement on Friday evening. My midwife told me to come in for a check up on Saturday afternoon. We got sent to Waikato Hospital for monitoring and the machine started showing regular contractions. Was this it? Or, were these those “Braxton Hicks” that are often discussed in every online forum? The doctor said she could check what was going on down there. I thought, “sure, why not?”. She then offered to do a process called a “stretch and sweep”. I had no idea what this would entail and thought again, “sure, why not?”. I don’t think my midwife was too happy about this because she said it was unnecessarily interfering if my labour was already progressing naturally. In hindsight, if I had known more about it, I probably would have declined the kind offer.

Oh boy did things escalate from then on. The contractions continued into the evening, rather close together (about every 5 minutes). I have a mild bleeding disorder so I needed to make sure I delivered at the hospital. This was in the back of my mind throughout the initial stages of labour. I was thinking to myself, “when do we go to the hospital?”, “what if I go too early?”, “what if I don’t make it in time?”. I think these questions are on most minds when in labour, especially first-time mothers. It’s not something that can be planned so it’s kind of hit and miss. For us, it was definitely a miss. My midwife told us to head to the hospital when the contractions were three minutes apart and 60-90’s in length. We had the three minutes going on but the contractions were regularly 50s long and not getting any longer. Thank god for technology, my contraction app was a life saver.

My birth crew came over to my house at about 10 pm on Saturday night. This included my hubby (who was already with me) my mum and my sister-in-law. We made the call to head to the hospital at about 11 pm. I had been regularly contracting for about six hours at this point. The pain was already excruciating and only getting worse. You don’t think it’s possible for the pain to be any more painful but then your body goes and proves you wrong. My midwife met us there and quickly checked to see how I was progressing. “Sorry Anj, you’re only about 2 cm dilated, you’re going to have to go home.” OH MY. WORST NEWS. Go home? How can I go back home? I feel like I’m dying and need to be in hospital. Ha. Nope… so off we went… back home.

The next few hours are a total blur. We were meticulously timing each contraction… waiting for them to get longer. 1am…2am…3am… nothing was changing except MORE PAIN. Poor Setti was trying to be helpful but we also knew he needed to rest because we had no idea how long this was going to go on for. I was telling him to sleep but was also screaming every 2-3 minutes so poor thing probably didn’t get any sleep. I think the whole neighbourhood could hear me. 4 am came around and finally something changed. My waters broke! Water was gushing all over the carpet. Wow, nothing can prepare you for that. What surprised me was that it keeps coming! I thought it would flood out then stop, but no, it kept trickling. I jumped in the shower and we made the call to head back to hospital. Towel between my legs, I waddled to the car. En-route to hospital and I recall saying, “Babe, I’m going to be sick”. Nek minute, vomit after vomit all through my brand-new SEAT. We had it professionally groomed but I actually think there’s still a little reminder on the seat belt. Nothing screams unique like a bit of vomit on the interior.

I walked into the maternity ward with a towel between my legs and vomit all down my front. My midwife said I looked like a drunk person walking into ED. I lay on the bed in the same room as earlier and eagerly waited for my midwife to check what was happening down there. “Anj, you are 3 cm dilated.” WHAT. That whole saga and I’m only 3 cm?! Wow, I was speechless. I remember thinking, I can’t keep going. My midwife said they will get me an epidural and I can get some rest. YES, REST.

About an hour later (an hour that felt like years) the anaesthetist came in and said, “Sorry, I don’t feel comfortable giving you an epidural”. WHAT THE F. Remember that bleeding disorder I mentioned… Yes that’s why. She didn’t want to risk it. I had seen a haematologist prior to labour and she said it was fine. There was a slight increased risk of things turning pear shaped but if I wanted one, I could have one. YEAH, NAH. Wow that moment was so devastating. I could see the devastation on my family’s faces. I think they just wanted the screaming to stop, ha.

I got an IV put in my arm so I could have a Patient Controlled Analgesia (PCA). There was a little green button I could push every two minutes for a quick shot of some sort of fentanyl. It was good, although you had to time things well. A combination of the drugs and the pain make the next few hours a real blur. I remember hearing my mum crunching on some sort of crackers. My sister in law bought snacks – life saver. I recall cold flannels on my head, squeezing Setti’s hand, mum rubbing my back, amongst a few other things.

At 8 am the doctors were going to reconvene and discuss the next steps. I think they were thinking of giving me an epidural because it was dragging out and I was extremely exhausted. Next thing I know I felt like I needed to push. The nurse had a look and said I was 9.5 cm! WOOHOOOOOO. She also said I needed to empty my bladder because there was no space for baby to come through. “Easy!” I thought to myself. NOPE. Getting up off the bed and boom, the most immense pressure on my pelvis. I couldn’t go. The nurse ended up draining my bladder with a catheter.

My midwife arrived back just in time. She was amazing. “Okay everyone, out of the room!”. She told all of the doctors and nurses to give us some space to get this baby out. It became a lot quieter in the room and these urges to push started taking over my body. Setti was holding one leg, my sister-in-law the other. Mum was up near my head sending positive vibes. I was almost going off the back of the bed. 12 minutes later – she was out. Straight onto my chest. I remember the gown getting in the way. I looked down at Setti, he was pretty much on his knees with tears streaming down his face. It’s all a blur really. I was so drained.

The contractions kept coming. I needed to get that placenta out for the pain to go away. Few more pushes and out it came. I thought the pain stopped there but boy I was wrong. Maija needed food so the midwife helped me latch her on. It was so so painful when she latched on! My poor nips. I find it incredible how the bubs just know what to do. Crazy.

Next thing I hear – “I need to check if you need stitches.” GREAT. My midwife had a look and sure enough, second-degree tear. We got that stitched up with the help of the PCA still attached to my arm #winning. I thought that was the end of it and we could get cleaned up but then I hear… “I need to check your anus”. Lord alive.

The first few hours of Maija’s life are all muddled. I was so tired. I don’t think I got to enjoy my baby girl straight away. I was too tired and dazed. I was happy we were both healthy. I had a shower and Setti dressed Maija. All of her clothes were too big! She was only 2.8 kg. Once I finally had a chance to rest at the birthing unit I was able to stare and take in this beautiful human being. I couldn’t believe it. We made her? Wow. Absolutely incredible.

Thanks to my amazing support crew and my incredible midwives, Mel and Georgia, for guiding me and delivering our healthy little girl. A special shout out to my sister-in-law Nicole for snapping some pics throughout the chaos.