Uterine Transplant

Happy 2018, everyone!  I’ve been meaning to write since I read this article about the first baby born in the United States from a uterine transplant:


A woman who was certain she did not want any more children donated her uterus to a woman who did not have a functioning uterus herself.  It’s kind of like a kidney transplant.  The recipient had functioning ovaries, so she was able to conceive using her own eggs and her husband’s sperm via IVF.  This is part of a larger study being done at Baylor University, and this was the first live baby that resulted from the study.  Previously, this had only been done in Sweden.

My limited understanding of transplant medicine is that because the organ is being donated by another person, then the recipient must be on immunosuppressant medications so that their body hopefully doesn’t reject the donated organ.  In some cases, the body does start to attack the transplant as foreign, and it must be taken out.  Which means that in the case of say, a kidney transplant, they’d need another kidney.

I’ve occasionally taken care of pregnant patients who’d had kidney transplants.  So there is a precedence for women who have had a transplant and are on immunosuppressant medications who have had babies.  I don’t know what the research says, but I figure if there was a concern for significant adverse outcomes in the children, then they would not allow this to occur.  Given the complexity of uterine functions that occur with supporting a pregnancy, though, this an entirely different level than a kidney transplant.

It did make me wonder why women would want to undergo the risks of having a transplant, and expose their babies to immunosuppressant medications in order to have a child.  After all, there is the option of surrogacy.  That is what Kim Kardashian is doing for her third child, since she had complications with her previous pregnancies.  With surrogacy, the child would still be genetically yours, but the difference is that another woman would be carrying the child.  So you wouldn’t be able to experience the pregnancy for yourself, but on the upside you would not have the transplant risks.

What says a lot are the statements from the physicians involved in this study.  One says, “We do transplants all day long.  This is not the same thing. I totally underestimated what this type of transplant does for these women. What I’ve learned emotionally, I do not have the words to describe.”  Another says, “A lot of people underestimate the impact that infertility can have on a person’s wellbeing.  It can have such a profound impact.”  The article goes on to say that uterine transplant is not a replacement for the options of surrogacy and adoption, but rather another option for couples.

Reading the statements above made me think about my own feelings.  Experiencing infertility myself has given me a deeper understanding of the feelings related to pregnancy and childbirth.  I understood the heartache of wanting children and not being able to.  But going into it, I didn’t think I’d be bothered so much by it since I’d already had a child.  And certainly, the feeling is different than for those who don’t have any children.  But I underestimated how disappointed I’d feel, and how I’d feel like my body was failing me.

The other thoughts that come up regarding these transplants is how important it is for many women to not only have a child that is genetically theirs, but to also want to experience the pregnancy for themselves.  As an obstetrician who sees the worst symptoms of pregnancy, I feel like pregnancy is often pretty miserable for many women.  And how often do I hear my patients, pregnant or not, say how good men have it.  After all, we women have to deal with periods, pregnancy, delivery, breastfeeding, and menopause.  And for the most part, the responsibility of contraception falls on us.

Despite all of that, the above goes to show how special it is to be able to carry one’s own child.  It’s not something that every woman wants, or should be expected to do.  But for those who do want to, it can be deeply disappointing to have that option taken away.  For the women who are candidates, it’s a remarkable achievement to now have the option to have a baby using a uterine transplant.


The Parenting Gender Gap

I have come across a couple of articles recently that discuss how moms still do more of the parenting work than dads.

This first article was referenced in the TIME Parents newsletter:


It talks about how dads are putting in more time parenting compared to years past.  However, the time moms spend on parenting has also increased, so the gap persists.  The author talks about how there is more pressure on parents these days, requiring more intense involvement, which is why the time spent parenting for both moms and dads has increased.  Furthermore, a reason for the gender gap is that when dads spend time parenting, they are usually focused on the parenting task.  Moms spend more time alone with the kids than the dads do, and tend to multitask and do other activities concurrently, like laundry and grocery shopping.

There is also a portion of parenting that is harder to measure in terms of time, and that is the management/organization portion.  When it comes to keeping track of everyone’s schedules, appointments, and so forth, moms tend to do more of the worrying and thinking portion of the parenting.

Which brings me to the second article:


This is an article from TIME which focuses on this very part of parenting.  The article starts with a mom who says that she’s the one who notices that the toilet paper is running low, and makes sure the pantry is stocked with multiple varieties of peanut butter that the different members of the family prefer.

It talks about how the women tend to be the ones doing the researching, the worrying, the organizing.  All of this thinking.  The author says that we need to free women’s minds, and decrease this burden, which will hopefully result in more inspiring use of our thoughts.

These articles refer to households with a mom and dad, with both parents working.  The second article mentions that men still spend more time doing paid work, but the total time parenting + working is about equal.  It would be interesting to find out if it’s more equitable with same-sex couples.

I find it interesting reading these articles, because my household is not like the typical households mentioned above.  My husband also works full-time, but works less days, just way longer hours on the days he works.  As a result, he spends more time alone with WZW than I do.  He definitely multitasks, and does so better than I do.  Although it’s hard to get much done with a toddler around, my husband manages to fix things around the house (currently a never-ending job for a new home), cook, do laundry, and run errands, to name a few.

When it comes to restocking items, we each have our jobs- I keep track of the diapers, baby food, and many of the toiletries.  Since I never bothered to get a Costco membership, my husband does all of the Costco shopping, so he takes care of things like toilet paper, dish soap, etc.  He keeps track of a lot of things that need to get done around the house.  Since I rarely have weekdays off, it’s usually my husband that brings WZW to his doctor’s appointments.

I’m very thankful that I have a husband who does more than his fair share of the parenting, which allows me to focus on my job, and not feel resentful being burdened by as much of the not-so-fun side of parenting.

Because my son spends more time alone with my husband and our nanny than with me, there have been occasions when he cried when they left and I was the one staying home with him.  He has never cried when I left him with the nanny or my husband.  He readily waves goodbye.  So that part of it does hurt a little.  But just when I was thinking that, I took him to my parents’ place during a recent workday, and when I left, he got upset and that made me feel bad, too.  So he does recognize me as a primary caregiver, and it’s a good thing that I have a nanny and husband that take great care of him.

In any case, juggling working and parenting is tough for both sexes.  For me, eating healthy is still a challenge.  We’ve tried many services thus far.  Blue Apron was probably the first of its kind, which delivers the exact amounts of ingredients you need and gives you recipes to cook on your own.  They do have great meals but they take WAY too long to cook.  And the portions were often small (at least for my appetite).  We tried Gobble, which is similar but requires less time, since some of the items are already prepared for you.  However the food quality is not as good.  We still do Sun Basket regularly, which is a similar service and requires less time than Blue Apron and has Paleo options.  Their food quality is better than Gobble’s.

On Mondays, we do Munchery.  They are a food delivery service that I think is only available in major metropolitan areas like San Francisco, Los Angeles, New York, etc.  They have pre-made meals, which for the most part are quite tasty, and all you have to do is heat them up.  It definitely makes life easier, especially since Mondays tend to be the busiest for us, but they don’t have Paleo options.  So most of the items have some carbs as sides, and given the price it’s kind of a waste of money if you don’t eat them.

We recently started doing Cook Smarts, and are liking it so far.  It’s a subscription service that charges $50 per year, and every week they have recipes including all Paleo options if you prefer.  The subscription gives you access to the recipes.  They make it very easy to decide how many (if any) recipes you want to make each week, and you can go to past menus.  Also, you get to decide how many servings.  We regularly make 6-8 servings to have leftovers.  Based on how many servings you decide, it generates a grocery list with the appropriate amounts.  If you make multiple recipes that week, many of the ingredients will be used in multiple dishes, which makes life easier.

So far we usually just do one, maybe two max, recipes per week and find that the dishes taste great, are Paleo, and not too difficult to make.  Best of all, because you do the shopping, you can choose to spend more money on organic items if you’d like, but overall save money compared to the delivery services.  Since we go grocery shopping anyway, it’s not any significant effort to add the additional items to our list.  They even have an option for weekend prep to make the cooking during the week less work.

Because it still requires time to cook, we’re not at the point that we can do it daily.  But it’s definitely a service that we’re finding to be worthwhile.

Since it’s been a while, here is a pic of WZW, now 17 months, getting very muddy in our new backyard:


Regretting Motherhood?

Since becoming a parent, I’m naturally more interested in parenting articles.  I discovered the TIME magazine Parents newsletter, which gets delivered to my inbox each Friday.  Belinda Luscombe, a TIME writer, rounds up links to various parenting-related articles each week, and also has a little advice on a different topic weekly, based on the child’s age.  I love the newsletters, and make time to keep up with them (unlike my Twitter feeds and Lenny articles, post-baby).  Here is a sample:


And if you want to sign up for the weekly email newsletter, you can go here, scroll to the bottom, and input your email address:


Recently, she’s had a couple of articles about people regretting becoming parents.  The first is about a researcher in Israel, who did a study about women who regretted having children.  Perhaps regret is too strong of a word.  In essence, in a society where women who don’t have children are looked down upon, there is this promise of fulfillment in becoming a mother.  But it “may simultaneously be a realm of distress, helplessness, frustration, hostility and disappointment, as well as an arena of oppression and subordination”.  These women love their children, and are not bad mothers.  But given the significant impact having a child has on one’s life, they now wish they hadn’t done it.  Certainly taboo to admit one regrets becoming a mother.


The second article is an anonymous post by a father with similar sentiments.  He became clinically depressed after realizing he did not want the profound changes in his life that occurred after having his son.  His wife doesn’t understand how he could feel that way, so it’s put a strain on the relationship.


The fact that both articles/posts ended up in the Parents newsletter means that they gained some buzz.  On the one hand, it’s still a bit shocking to hear that a parent regrets having children.  But on the other hand, it sounds like it’s more common than you’d think.  And these articles are raising awareness.

I always wanted to have kids.  Whether that was due to expectations from society and my parents, I don’t know.  But I was old enough when I got married to have a sense of how life-changing it is to have kids.  So when I got married, I knew I wanted to have kids, and it was a decision I had made independently.  My husband wanted children as well.  We were lucky enough to be able to plan it, and not to have had trouble conceiving.

Even then, it’s been tough and I relate to the sentiments of the articles.  Even despite wanting a child, having a supportive partner, planning a pregnancy, and having a pretty good idea of what to expect, it’s still hard.  Really hard.  Granted, I didn’t quite know what it was like and how hard it was until going through it myself.  And it’s hard for others to explain what it’s like to get so much joy from your little guy.

But the chronic sleep-deprivation, and general demand on my life hasn’t been easy.  I have the type of job where I work 50-something hours a week, and I can’t exactly half-ass it.  So it’s tough when I’m chronically tired, but still have to be at the top of my game at work.  I feel like all I have the time and energy for is work, and whatever is required to take care of WZW- the breastfeeding and pumping (which I hate every day), getting up at night for him, and just in general watching him so he doesn’t kill himself these days.

He’s sleeping better, and taking longer naps, so it is nice for getting more stuff done.  But what I find is that even on weekends, it’s hard to catch up on sleep.  There’s always stuff I want to do, even if it’s sitting on my computer like this.  I’m introverted by nature, so I need to decompress and have alone time.  That is much more difficult given all of the demands of having a baby.  So between the lack of sleep and lack of me-time, I often don’t feel settled.

So particularly for my patients who did not plan their pregnancies, don’t have a solid relationship with their partner, don’t have financial stability, or just were ambivalent about children in the first place, I can see how one may regret parenthood.

For me, the other ramification of chronic sleep-deprivation is that my health has suffered.  When you’re tired, extra hungry from breastfeeding, and don’t have any free time, your food choices (and amounts) suffer.  It depresses me that I’m 20 lbs heavier than I was pre-pregnancy.  Or at least at last check.  I don’t even want to step on the scale any more, since it will only make me feel worse.  And the thing is, I gained weight after I initially lost much of the pregnancy weight.  So I think it’s mostly from the chronic sleep-deprivation.

I worry about this not getting better for a while.  Many parents say it took years for their kids to really sleep through the night.  Also, we’d like to have another child, and given my age I can’t wait that long.  But I worry about whether I can handle a pregnancy and another baby since I’m already having a tough time.

What it comes down to is that I don’t regret motherhood, and I hope we are fortunate enough to have a second healthy child.  But I am well aware of the sacrifices that come with that.  And right now, my fear is that I will remain this fat forever.  Yes, it’s superficial, but my self-esteem is tied to my weight and appearance.  As well as my health, which is ultimately more important than my appearance.  I’m afraid of being this heavy permanently, or at least for a good number of years.  I probably worry too much, but I think that’s the sleep-deprivation talking. 🙂

Here’s our newly 9 month-old little guy, who has turned Mom and Dad’s lives upside down.  He’s wearing the jinbei-san my mom got him in Japan.  Also referred to by my husband as his Japanese dashiki.