Ana
"Hello Ana." Doctor Greene smiles as she comes into my room with Amanda, my former midwife with all the other kids. It's great to see her actually as there's no one else I'd want as a midwife.
"Hi." I say shyly. I'm still very unsure of people who's aren't here day in day out. Even if I have known these two ladies for years it's still tough to trust. I know they won't hurt me.
"How are you?" Amanda approaches me cautiously and I give her a smile and reach for her to give her a hug, trying to show I'm still the same Ana and I'm not fragile. She returns the hug and smiles.
"I'm ok." I tell her.
"If we can get you weighed, bump measured, do a sample and then Dr Greene can do the ultrasound." Amanda says getting straight down to business as there's a knock on the door. I look as a sheepish looking Christian pokes his head around the door.
"Come here." I tell him and the relief floods his face. I knew he'd want to be here I just didn't know if I could ask him to be. I'm glad he's shown up though that's made it easy.
"Ok let's get you weighed. Have you got any hard flooring?"
"Bathroom." I reply as Christian takes a seat on the bed and watches Dr Greene get out the portable ultrasound.
I'm nervous stepping on the scale as I know I've lost a load of weight and I don't need the judgement from Amanda or Dr Greene.
I'm shaking as Amanda writes down my weight but she doesn't say anything, just gives me a gentle smile.
"I want a bump measurement too so if you want to get on the bed." She says and I glance nervously at Christian, she would normally tell me my weight but she hasn't this time.
On the bed I look at the ceiling as measurements are taken of my practically non-existent bump and again Amanda writes it down and says nothing.
"Ok Ana lets have a look at baby." Dr Greene says stepping up beside me with the portable ultrasound. Christian comes beside me and takes my hand. "It won't give me accurate measurements. Did I give you an estimated due date?"
"I think you said around the beginning of February." I reply nervously.
"How many weeks do we think you are now?" She asks still moving the Doppler along my stomach.
"Eleven to twelve." I reply, because I didn't have a proper period after stopping the pill it's impossible to work it out from the first date of my last period.
"Ok...well most importantly there is the baby's heartbeat." She says showing us on the little monitor. I breathe a sigh of relief because I'd been dreading losing this baby with everything going on. "I'm not confident enough to use this measurement as a guide to give a due date." She adds and I nod, I understand that, she's explained already. "But I'm happy that the baby is doing ok and that's what's most important right now."
She gives me a towel to wipe my belly and turns the machine off. There will be no photo from this one but that's ok. We'll get there eventually where I will be able to go and get a proper scan.
"Ok so we are going to go and have a word with Tamara, John and Grace and then we'll come back to see you before we leave." Amanda says gently as she tucks here dark locks behind her ear.
"There's nothing wrong?" Christian asks shakily still holding my hand as I lift to sitting. Amanda looks at Dr Greene awkwardly which gets my heart racing and then she looks back to us.
"I'm concerned about Ana's weight." She says softly and I roll my eyes, we had similar conversations in all my other pregnancies too but they always reassured me it was ok as long as I gained. "Ana this isn't like with the twins or Teddy or Phoebe." She says having clocked my reaction.
"How bad is it?" Christian asks looking a bit pissed.
"Well typically, in the past Ana was always a healthy weight coming in to me, a healthy weight when Ana isn't pregnant is around 107 pounds. At this point in pregnancy I'd really want to see her at around 115 to 120 but Ana is just 98 right now." Christian squeezes my hand.
"What does that mean?" He asks gruffly. This isn't good, Christian has enough of an issue with food as it is.
"Well, coming to the end of the first trimester I'm not overly worried because when women have bad morning sickness weightloss can be common I'm concerned at just how slight you've become Ana." She fluctuates from speaking to Christian to me which is annoying I just want to know what's going on and what's the problem.
"The risks are significant, malnourished foetus means increased risk of miscarriage, stillbirth, preeclampsia, low birthweight weight, increased risk of SIDS in the first month of life." Dr Greene intervenes now obviously not happy about how lightly Amanda was going around it. Tears build in my eyes, I'm killing my unborn child. "I'm not saying it to upset you Ana it's my ethical duty to make you aware of the risks and the complications that this could cause."
"What do we do about it?" Christian asks.
"I'd like Ana to gain two pounds a week in the second trimester. I think we need to be looking at supplements, drinking additional calories. I think we should get a dietician involved." Amanda says wanting to try and reassure us in her own way but failing miserably. I've just zoned out now my mind firmly on the death of my unborn child that I'm unintentionally causing.
"Ana...Ana..."
"What?" I ask looking at Christian.
"Dietician. We can get someone over today?"
"Sure." I say brushing him off I just need to think and breathe. I get up and go straight over to the balcony. I can't think with these thoughts swirling my mind and I need to focus.
Tamara
"None of that is surprising." I say looking at the OBGYN and the midwife who have filled us in on Ana's pregnancy and their greatest concern is her weight. "We've done what we can, we finally have her eating two meals a day. Short of giving her a tube I don't know what you're expecting us to do."
"Well we're not expecting you to tube her for Christ sakes but we do need her gaining now she's going into the second trimester. She's agreed to see a dietician and I'm hoping that will help."
"How did she take the news?" Jamie asks from beside me.
"She zoned out and then went out onto the balcony, quite literally shut us down."
"Fuck." I say jumping to my feet and John and Jamie both follow me as we make our way down the hall to Ana's room.
We find Christian sitting on the edge of the bed looking very depressed. John goes over to him while Jamie and I make our way out onto the balcony to Ana.
Jamie grabs my arm as soon as we step outside onto the balcony. Ana is sitting with her legs crossed, her hands on her knees, palms up, her back straight as an arrow.
"Meditating." She mouths and I smile and nod, well meditating we can cope with. Withdrawing and possibly shutting down again we can't. We'd have no choice but to admit her if she goes downhill again.
Jamie slips past me and sinks to the floor in front of Ana. I smile at her as she takes the same position and I leave them to it, going back into the bedroom where John is chatting away with Christian.
"You know I have an issue with food..." Christian mumbles shakily as I come to a stop by him and John.
"I do Christian but you and I both know this is something that's way beyond your control." John says and Christian tightens his fists on his his knees, he's clearly struggling with this.
"Christian, we'll bring a dietician in, we'll get her overall calorie intake up, once we do that there's no reason that she won't gain the weight she's supposed to." I reassure too.
John looks at me, Christian is looking blankly to the side of me, his mind clearly not here with us.
"Why don't you go hit the Gym Christian." John suggests. Christian turns to look at him and the he looks to me and sighs.
"Ok." He says before getting to his feet and walking off. I look at John who shakes his head at me, there's obviously more to this with Christian than I know or realise but that isn't my concern, he's not my patient.
"Ana ok?" John asks as he gets to his feet also knowing I'm not going to enquire about Christian.
"I think so." I smile gently. "She was meditating, calming herself down and grounding herself I suspect. Jamie is with her. We've got a lot of work to do John."
Jamie
"How are you feeling?" I ask when I realise Ana is looking at me.
"I'm upset." Ana admits. "He doesn't get to take my unborn child as well." She says through gritted teeth.
"No he doesn't." I agree gently, even though she's meditated I can see she's still very worked up about this.
"I feel so guilty." She whispers, the shame marring her face.
"Why?" I push, I am so glad she's being open about this and while it should be Tamara doing this with her, seeing as she's opening to me I'm not going to shut her down. Tamara wouldn't want me to anyway.
"I should have known better." She says. "I knew I wasn't eating enough but...I just couldn't."
"When someone is raped, they often feel like they lost control." I say gently. "Did you feel like that?"
"I guess." She replies shrugging, while she's open with me about how she's feeling she's clearly not in the most cooperative mood.
"Were you using food as something you could control?" I ask because if she was it could be easier to deal with it than we first anticipated.
"Maybe a little." She shrugs. "But I felt sick too, all the time, and so food hasn't exactly been appealing to me."
"Ok. Look we can have a dietician here this afternoon Ana, it's not too late to change this around, you're not dangerously underweight, so at the moment no one is really worrying about you or the baby being malnourished it's just what could happen if we don't do something about it." I try to be reassuring because I think that's just what she needs right now. She probably feels like everyone is against her and the last thing we want is for her to think she's being forced to do something she doesn't want to do too as that could complicate things even more.
"I can't lose this baby." She whispers and I reach for her hand and take it in my own.
"We'll do all we can to prevent that." I say because truth is it's completely out of our hands, sometimes these things just happen but we can minimise the risk and that's what we're going to do.