Katie Pinke

In July, we celebrated Anika's fifth birthday. She's the baby in our trio of kids, although we thought she would be a big sister by now. My dream of having four children was as tangible as a positive pregnancy test, but a fourth child wasn't meant to be.

Last fall my husband and I were elated to learn we were expecting again. Six weeks into the pregnancy I experienced severe cramping. I suspected a miscarriage was imminent but knew doctors wouldn't be able to do anything to stop it. I stayed home. Thinking I could somehow reverse my symptoms, I called my doctor's office to schedule my first prenatal visit.

By early evening, I was sweating and my pain was far more agonizing than anything I had experienced during labor. Maybe it was my appendix? I lay on the bathroom floor and texted my husband.

Minutes later we were headed to our rural North Dakota hospital in Wishek. The pain was unbearable--and my emotions were erupting amid the uncertainty. After a series of questions the doctor and nurses, all of whom I know, decided to send me to Bismarck, 100 miles from our home, in case my pain was related to an ectopic pregnancy.

Ectopic? I remembered a coworker's wife having an ectopic pregnancy, and they weren't able to have children again. Surely this wasn't happening to me--who at 18 delivered a son, and then 10 and 12 years later had two more children. I've never had any fertility issues. I've never had a miscarriage.

"Could I wait a little while before heading to Bismarck?" I asked. My son's high school drama performance was scheduled to start in less than an hour. My doctor said absolutely not, and recommended I go by ambulance to Bismarck.

There was no way I was going to ride in an ambulance. My husband drove me to the emergency room at Bismarck's St. Alexius Medical Center. After bloodwork and ultrasounds, my OB-GYN arrived. She confirmed I indeed had an ectopic pregnancy, which had to be removed immediately. I was heading into surgery.

An ectopic pregnancy occurs when an embryo implants somewhere other than the uterus. Most often that is in a Fallopian tube. In my first ectopic pregnancy (yes, you read that right -- I have since experienced a second loss), the egg was actually outside of my tubes near an ovary, so surgery was required.

One in every 50 pregnancies is ectopic. After you've experienced an ectopic pregnancy, there's a 30 percent chance that history will repeat itself. If detected early, an ectopic pregnancy can be treated nonsurgically with Methotrexate injections, which is what happened my second time. Left untreated or undetected ectopic pregnancies can be life-threatening. Detected early your ability to preserve the chance for future healthy pregnancies is maintained.

While I quickly recovered from surgery last fall and was grateful for the immediate medical care I received, I didn't expect the emotional rollercoaster that followed my loss.

I have friends and family who have experienced deep, life-altering losses, much more brutal than anything I have gone through in the past year. Yet I see these same people living with purpose and joy. Their courage reminds me to put one foot in front of the other. I have been reminded to keep going, to not quit and to focus on being at peace with all that I have in this life.

Thankfully I have numerous reminders of God's faithfulness. The arrival of my first niece was the greatest joy November could have delivered. My son's basketball schedule kept me on the move during the winter months. This spring when I received news of my second ectopic pregnancy, I had a string of speaking engagements I couldn't cancel. My doctor let me continue my activities with a few modifications to my travel.

Every time I had an appointment in Bismarck, I would purposefully pray on the way home for the blessings I have. I thought about every friend and family member who has become an adoptive parent or foster parent, about the hard journeys for many with fertility treatments, about friends who have lost children in accidents and friends who are content to never be a parent and instead share their love with neighbors, community kids and nieces or nephews.

While I could dwell on what was not meant to be, I'm choosing to focus on the many blessings that are right in front of me. We all have a story, and I take to heart the words of Theodore Roosevelt: "Do what you can, with what you have, where you are."

Katie Pinke writes The Pinke Post, a prairie perspective from the heart of rural North Dakota. You'll find her blogging about family, food, farming and the chaos of being a working mom at thepinkepost.com.