Moving on

So I made a baby. The path I took to get there was only slightly unconventional - it would be incorrect to call this an "infertility" blog, it's more of a "trying after a loss" blog, but my experience has inextricably linked me to the IF/loss/etc. community. I have empathized with and appreciated and internalized the struggles of many others and have learned so so much in the process. There are so many of us who have struggled to bring a healthy baby home and who continue to struggle to do so, and there are almost as many reasons for the struggle as there are stories so it's difficult to put a label on this community. It's not just IF, and that in itself contains so many unique challenges. It's also different varieties of loss, and includes adoption stories, SMC stories, AI and the many strata that that term entails, so many different approaches to the ultimate goal - and for that reason I think it is the goal that unites us, in a way, more than the particular challenges we face. Sure there is nothing like sympathy and advice from someone who has actually walked in our shoes, but my perspective has been broadened, my appreciation heightened, by the breadth of experiences in "these halls," moreso than communicating with people who have, for example, been through a molar pregnancy. Both are equally valuable, those who have walked in my shoes make me realize that I am truly not alone and that there is hope for my particular situation. But the larger community has made me a more sensitive, more educated, more appreciative individual. A better person. And for that I will be forever grateful.





This is my story, my adventure, and I've documented it here for anyone that might come across similar issues in one way or another. For anyone who can benefit in any way from what I've been through. It is a story of babymaking.





For the first time in my life, I feel like I've been handed the moon. Like I'm not the unfortunate statistic but rather, one of the lucky ones. Like I've been accorded my wildest dreams - there is nothing in my life that I've ever wanted more than a healthy baby and that's exactly what I got. It wasn't as easy as it is for some, but far easier than it is for many. And thanks to others in this community I believe I can properly appreciate this miracle in a way that I could not have had I never gone through my struggle. This is where the unspeakable misery and fear and anguish that we all share pays off. We are better people for having been through it, and we do enjoy and appreciate parenthood more (and thus make better parents), I am sure of it. All along this journey I was told about how susceptible my plight made me to post partum depression. I was depressed pre-partum for god's sake, there was definitely potential for disaster once the baby arrived. Would the end justify the means? Would I be depressed at the disappearance of the intense anticipatory process? Would I wonder, like my friends have wondered (momentarily usually) "what have I done?" No. I couldn't be more alive, more rejuvinated, inspired, in love. I am in love with my baby and in love with my circumstance in life, notwithstanding my anxieties which, I suppose, will always exist.





So I am moving on from this. My struggle has changed and so I feel there may be a better forum for further musings. A new blog. A new name.





I've entitled it "Everything After." I considered a few other titles - one that I nixed was "Afterbirth," ha ha ha, gross. Also falling by the way side "Happily ever after" (too optimistic for me, don't want to jinx anything) and "The other side." This last one I initially thought as incredibly appropriate because it's the phrase I've always used when approaching a particularly difficult challenge. Like finals, or a speech,...or birth: "See you on the other side," ...just to remind myself that it will be over soon, I will survive to see the other side...or sometimes "see you in the sunshine." But the phrase is most effective when you really are inextricably and necessarily on the other side. When you're done. When that experience is behind you forever. My experience in this forum is more continuous than that. My future in parenthood will continue to be informed by my loss - I am on a continuum. For one, there may be another baby in my future. I'm not "on the other side" with respect to my struggle, struggles in this area will continue, I'm not there yet, so to speak, so I've decided against proclaiming that I've arrived "there." "Everything after," I feel, properly includes everything after the birth of my first child. It's not overly rosy, it doesn't lock me into having more babies or not. It's the other side of my babymaking struggles but a continuance of my life story and just the beginning of my story of motherhood. I've overcome that brick wall. It will be motherhood-focused, infused with thoughts on anything babymaking related, parenthood related, and of course anxieties and true-life adventures. I look forward to the new forum as a clean slate. A new beginning. A new chance to make the best of whatever life throws my way. And a chance for renewal and resolution. A chance to be more present and enjoy more of the moments for what they are rather than living in fear of what the future may or may not bring.

As a side note I didn't realize until a couple days after I chose this title (and after I wrote the bulk of this post) that I probably subconsciously derived it from a Count!ing Cr0wz song called "August and Everything After." I was obsessed with CC for a good many years and derived a lot of meaning and fuel for teenage/undergrad angst from many of their songs. I had a relationship in college that was built in large part on our shared interest in the band. How funny that this would pop up in my head now...and that the title is August and Everything After. Of all months. How funny and how appropriate.

The link is here. Welcome to our new beginning. And thank you, a million times, to all of you for helping me immesurably along this journey.

Birth Story (belated...sorry)

Since the birth wasn't particulary eventful, this is more like a "birth and hospital stay story." I warn you, it's on the long side.

The c-section was a piece of cake. I had fretted about it a little in the couple days before, I started ruminating and panicking about the epidural and the looming recovery process, but it was seriously nothing. It hurt when they put the IV in during prep but that was the worst of it by far. The rest was just weird. The numbing agent before the spinal felt like a tiny pinch, I didn't feel the spinal at all, and I had an anesthesiologist with an awesome, bubbly personality, he really made me and DH feel comfortable and excited. DH was offered the chance to watch the baby being pulled out and to cut the cord and to my surprise he said yes to both. He said it was like something out of the discovery channel. I'm not sure how he didn't pass out. The only other unpleasant part, after the IV, was feeling the pressure of them pushing the baby out from the top of my ute. I felt like I might break in half. I couldn't feel any pain at all but it still took my breath away to be manipulated like that - there were bruises on my stomach from the ordeal. They held the baby up for me to see once he was out. He wasn't crying, he was all blue, he looked like an avatar baby. No one was acting like anything was out of the ordinary but I needed to hear that cry. "Why isn't he crying?" I asked after what seemed like an eternity of patience. "It takes time, this is a big transition, blah blah blah" came the answer. I was asked to have faith once again. Every minute felt like an eternity. This is it, this is when we find out, after four months of this CPC occupying at least a fraction of every thought that passed through my head, this is when the truth becomes known.... He did cry eventually, they had to get a lot of fluid out of him before he could. And his cry sounded healthy. I knew the doctors would be quickly examining him as I lay there on the table and I didn't hear anything alarming coming from the other side of the drapes...only happy sounds. They finished me up, brought the baby closer to my face momentarily so I could see that he had turned from blue to pink, I gave him a kiss, and then they promptly sent the baby and DH to the nursery while I was wheeled into recovery. The whole thing lasted about 40 minutes. 9:30 appointment, baby was technically born at 9:58.

All along, at birth classes and even in the surgery prep room I was told that in the event of a c/s, "if everything was ok" the baby would be brought to me in recovery after a brief trip to the nursery for a bath and a quick check, that we could start breastfeeding and bonding, etc. I lay there in recovery - stunned at what had just happened. A little life had been pulled out of a 6 inch incision in my belly. DH had seen it all. I heard him cry. He was 7.2 lbs. We had a child. And the most exciting thought, he seemed healthy.

The wait was long and as I lay there, marveling at how pregnant I still looked and trying not to freak out that I couldn't move my legs, I resolved to be more positive going forward. I resolved not to worry as much, to enjoy every moment despite there never being a guarantee. And to definitely not worry that the nursery was taking so long to return my baby. He was in good hands, I told myself (more on the nursery later). My parents and sister arrived and they and DH kept shuttling back and forth from my bed to the nursery reporting that he looked fine, that now they were bathing him, now they were weighing him, etc. etc....but they were keeping him for some inexplicable reason - where was my baby? Don't freak out, these things take time, no more obsessive worrying, have some faith for once Astrid. I was keeping it together pretty well 20 minutes into this waiting game but then the surgery nurse tending to me mentioned, "It never takes this long." My heart sank. Something was wrong. And no one was telling me what. Once again my hard-won inspiration to be more positive was met with a slap in the face. I felt so stupid for having mustered some actual faith for those few minutes.

Finally the word came. There were a couple problems - rapid breathing that wasn't normalizing and low blood sugar. For all I knew these were signs of impending doom and when they told me they were both pretty common, particularly in c/s babies, it was hard for me to believe. But it turns out, once again, I should have listened. The baby did spend a good 2.5 days in the NICU but his 'issues' were easily and completely resolved. Every nurse and doctor I've talked to since has been reassuring that they are nothing to worry about, he needed a boost of glucose and some monitoring, his breathing stabilized on its own, and now it's all in the past. He's a healthy baby. I cry every time I really stop to think about it and every time someone reminds me that he's healthy and strong. This is all I've ever wanted.

Once he was released from the NICU and I got familiar with the operations of the nursery staff I kind of wanted to send him back to the NICU just for the level of care and attention he was paid there. The regular nursery was a nightmare. I had heard such good things about this particular maternity unit and maybe I caught them in a bad week but it was seriously a problem. I opted to do 'demand' feeding during the nights which means that I would send the baby to the nursery in the evening and they would call me when he wanted to eat during the night and bring him to my room for a half hour or so and then bring him back to the nursery when the feeding was over. DH had to stay at the house with the dogs during the nights and I needed to rest and recover and was not very mobile so this was the best option. Anyway, during the first night the first feeding went fine, but after the second feeding I called for the nursery nurse to pick him up and nobody came. I waited 20 minutes and then called again. Frustrated because I got SO little sleep in that hospital (if it wasn't a nurse stopping in to wake me up it was the food service or the janitors or the doctors or the photo company or the baby's doctors or the baby's nurses or the lactation consultants or administrators...I could go on. The nurses kept telling me to 'get some rest' because I would have a better chance to rest at the hospital than I would at home. That was a fat lie) that I resented them eating into the next shift by taking their sweet time. Turns out my nurse was on break so they told another nurse to pick him up. Then another 20 minutes went by with no nursery staff. I didn't want to call again, because if I had to call a third time, what kind of people was I sending my baby back to? What disasters could befall us at the hands of this kind of incompetence. Three times I had to call? Seriously? I did call though, I didn't really feel like I had much of a choice. I still didn't feel confident taking care of him by myself - I could barely stand, I didn't know how their particular blankets swaddled, I was terrified of hurting him - dropping him, wrapping him wrong, terrified of suffocation, etc. while I was sleeping. But I knew I had to sleep if for no other reason than to keep myself from getting sick and to make sure my milk production stayed on track. These are all the rationalizations that went through my head as I dialed a third time. I also considered chewing them out on the phone but decided to wait until after we were discharged. I didn't want to upset the people handling my newborn. Once they picked up:

Me: "I've called a couple times now to get my baby picked up, I was just wondering what was going on."

Instead of apologizing, the girl at the other end got defensive and blamed the nurse - it was so unprofessional.

Nursery Girl: "Hmm, I don't know why, the nurse I told is standing right here, I'll tell her again [I could hear her eyes roll over the phone, like this wasn't her problem at all]."

The nurse that arrived didn't speak much english and could not recall from one second to the next what I had told her about "how long on each breast" and whether his diaper needed changing. "20 minutes on each breast?" she asked, after I had slowly and distinctly told her it was 15. Then she picked him up by the armpits without supporting his head and I almost lost it. I actually had to say "Watch his head!" I wanted to run down the hall after them, what kind of mother was I? Fortunately the night ended a few hours later and the baby was returned to me unharmed.

And then the next night, our last at the hospital, the situation repeated itself. I called twice and no one came. Before I had a chance to call a third time my nurse offered to bring him to the nursery. I hesitated but then allowed it on the condition that she make sure they know he's there, that she leave him with someone. I liked my nurse and I trusted her and away they went. That was around 4:30am. At about 7 am I got a call that set my entire body into a panic:

"This is the nursery [awesome, I thought, right on schedule, they're sending him back for a feeding and I'm just going to hang onto him this time], we were just wondering if you could send M back to the nursery, the doctors are making their rounds."

FUCKERS YOU HAVE HIM! Is what I wanted to scream into the phone. I can't even remember what I actually said, it must have been something close. They said they'd check again, great. I asked them to kindly call back when they found him. And they did find him. Again no apology. Their excuse was that part of one name tag was covering part of another name tag, I couldn't believe the incompetence. And all was well with the world again. I asked them to send him back as soon as the doctors were done because he was due for a feeding and they said it would be about 20 minutes. Then nine o'clock passed and I called again. "Sure right away," was the response. Then ten o'clock. And I called again. This was getting ridiculous. It had been almost six hours since his last feeding. They kept assuring me that he was sleeping soundly so I tried not to worry but I was pretty firm about wanting him NOW during this last phone conversation. Sleeping or not, six hours was pushing it - call it maternal instinct. When they arrived with him they mentioned he was slightly jaundiced, not badly, not anything to really worry about. "What should I do?" I asked, knowing next to nothing about jaundice except how common it is. "Just feed him more often," was the answer. HATE !!!! I hated them. All of them. Fucking Idiots. I had been trying to feed him for the last three hours. What. the. fuck. I am still contemplating writing a scathing letter. The comment card I got doesn't have room for all the above colorful stories of incompetence and the resulting "maternal stress."

Anyway, it's been two weeks and I am recovering well. I could stand upright and walk a few steps by the night of the c/s. I stopped pain meds at one week. I could function pretty normally as soon as I got home - doing laundry, getting around fine, just no lifting or bending. By two weeks I feel pretty much back to normal, I pick stuff up off the floor, I go on long walks, but I'm still afraid to lift things like the carseat and stroller - anything in the 20-30lb range still seems scary - I've heard some horror stories about c/s incisions opening up, getting infected, milk drying up, etc. and I don't want to risk it. So I feel fine but am being cautious. My dr said I could lift any weight I want as long as I just use arm strength and don't strain my core muscles. Stooping over to disloge the carseat from the base and lifting it up and out I think definitely strains the core muscles, at least a little. So I'm waiting on that one. I might try the baby bjorn soon because not being able to run errands is a pain. I need more onesies! And some sleep sacks. The LO has already decided that swaddling isn't really for him.

I've decided that for me, c-sections are easy. I would definitely do it again. Labor seems so incredibly challenging and scary and daunting in comparison, I do sometimes feel like I took the 'easy' way out. But I have no guilt about it - it's just the way things went for me.

Most importantly, I am so in love. Every moment of every day. I've gotten no more than 4 hrs of sleep at a time since we left the hospital - and usually it's more like 2 - but I don't care. I have no complaints. I have plenty of worries as a new mom of a tiny fragile infant, but I'm refusing to let them rob me of the moment, so to speak. Come what may I am going to enjoy every moment with my son as many or as few as those moments may be. I haven't had a touch of the baby blues or anything close to PPD (knocking on wood now). I think my gut feeling about all of that is proving true - my relief and heightened appreciation of how miraculous a healthy baby really is has vaulted my mood into the heavens, I am full of awe and appreciation and humility and there just isn't any edge of depression. Like I said, there's plenty of anxiety about whether this breathing pattern is normal, whether I'm doing everything I can to avoid SIDS, how to dress him in this heat wave, whether or not to take him into public this young, how to politely protect him from kids for the first month when we have a seemingly never-ending stream of people wanting to visit. I'm dealing with this aspect of myself the best I can, unfortunately I feel most comfortable when I can control all these elements and I have no doubt that it's irritating DH but he appreciates what I've been through and is being heroic about the whole situation. But like I said, these are not things I internalize. I do everything I can do to protect him and I let go of the things I can't control. And I don't feel the least bit depressed so far. It helps that feeding is going perfectly and has from day one. And that he sleeps according to a pretty reliable schedule. And that DH and I were pretty much home bodies from the beginning so we don't see our lifestyle as cramped by this new addition - I always wondered whether I would be able to sympathise with my friends who insist that "you can't do anything when you have a baby." I'm happy to report that I still find that remark incredibly naive, ignorant, and irritating. I know how lucky I am. I don't take any aspect of this for granted. I am soaking it all in. It's a really refreshing side of myself and I love how it makes me feel. I love having something more important than myself to occupy my thoughts and actions. I love being a mom.

Quick update - he's here!!

I will send a more thorough birth story when I have the time and facilities - I'm writing in a rare quiet moment at the hospital...

He arrived this morning as scheduled at 38w 4d and weighed in at a respectable 7lbs 2oz. I don't have a length measurement as yet. It's been kind of chaotic.

He has the face of an angel and tons of hair. I wish I could say he's perfectly healthy in every way but he had low blood sugar and was breathing too fast when he came out so he was whisked away to the NICU, although I've been told by the nurses that these are common problems with cesarean and breech babies. I'm having a hard time coping with these first few crucial hours without him, this is not how it's 'supposed' to be (but when is it ever?) but his breathing is fine now and he's getting glucose until they ok us to start breastfeeding - maybe tomorrow - at which point they'll assess how he does without the supplement. The hope is that we'll both be discharged at about the same time.

It physically hurts to be without him (after the delivery room I got to hold him briefly once while I was flat on my back) but he is doing quite well by all accounts and for that I feel so fortunate and thankful.

Ding!

All done. 37 weeks! This baby is ready for the world.



37 seems like a very long number when you're talking in terms of weeks. Weeks waiting, weeks wondering, weeks talking and planning and making the biggest decisions of your life in anticipation of the biggest life change imaginable. It's a long wait for anyone. Probably a first-time-mom in particular. This is a pretty amazing milestone. There's a full size, all-ready baby in there! I'm trying to get the last of the nursery together today and keep imagining him on the other side. Holding him in the rocker, trying to transfer him into his crib without waking him up, will he be able to enjoy the mobile if I put it this way or that... It's so strange. I installed the car seat base with C yesterday, we have a LATCH system so it was pretty easy. Strange again though.

And I just had my 37 week checkup. Baby is still in persistent breech. And get this. We got a date.

August 10, 2010.


THATS ONE WEEK AWAY.

AAAAAAAAAAAGGGGGGGGGGGGGGHHHHHHHHHHHHHHHHHHH.

Un-be-freaking-lievable. Still have a lot to do but am glad it's as soon as it is. I am ready for the next chapter.

Thirty Six Weeks

Unbelievable how long the last 36 weeks have been. Well, the last year and a half. I have never spent so much time just waiting. And it's no way to live, let me tell you. I've been trying to turn over a new leaf by spending more time living and less time waiting, but man, it's not easy if you're not used to it.

I had my dr's appointment today. Fundal height 36, perfect. I needed that. Having not heard the measurement last week and getting a new dr this week - one who measures under the clothes instead of over like my obg, I was prepared for the number not to match the week. But it did. Thank goodness for small miracles.

The new dr was dry as toast, but nice enough. He said it looked like my pregnancy had been going well. I corrected him by explaining the two hiccups - the cpc and breech position. He said what the other two or three dr's I've talked to about the cpc have said. That it's relatively common in terms of findings that "require a phone call," as he put it. I didn't bother mentioning that I hadn't received a phone call. He said he'd never seen it, by itself, result in a problem, he knows it's unsettling, he can't for sure say everything is fine. He confirmed that common practice around here is to not follow it up and that consistent fundal height growth is a good sign.

He's also the third doctor to say that breech is not a warning sign to be read into at all, even given the earlier cpc. He was more pleasant than my regular OBG, and explained the various reasons babies can be breech. I didn't have to play 20 questions with him to get information, he just offered it up. Pelvic shape, cord placement, where the baby happens to be when it gets too big to move much anymore...he said the real question is why more babies aren't breech.

But I found another blog recently of a girl just like me who had cpc's at her u/s, also a 2 vessel cord, and her baby ended up being breech. The doctors assured her the breech had nothing to do with chromosomal issues, she blogged about being relieved by that. But then the baby did have chromosomal abnormality. Not T18, something even rarer. Sure there are also stories I've found that go more like this: cpc + breech = healthy baby, but as the days wear on and new developments make themselves known I'm finding myself in a smaller and smaller universe of people who have been through it. It makes me so angry in the 'life's not fair' kind of way. Why me? Why do I have to worry about this sh---.

But then I also saw that one of my birth club members on B@by C3nter lost her little boy at 36 weeks to a cord accident and it broke my heart. And it made me feel guilty that I haven't been embracing every minute I have with this little one who seems to be growing and strong and probably just fine. In my self-pity I've neglected to look at the positives and to embrace what I have, what makes me lucky. As angry as I am that these remote possibilities are landing in my lap, my LO feels entirely compatible with life from what we know and from what we've seen and that makes me lucky and I shouldn't pass that over in search of a guarantee that will never come. Not even after he's born, I realize.

In true fashion, I continue to avoid anything 'normal' going wrong in my pregnancy. Half my birth class had GD, I didn't. And the percentages for things like pre-e and group beta strep are high relative to the percentages for CPCs and breech and I don't have those either. Why do I win the 1:4 and 1:10 risks and not the 1:100, or 1:1000+. Of course the rational side of me says there's no way I can just be prone to bad luck. I'm not actually more likely to lose when the odds are more remote, but the consistency of how things have worked out that way makes my head spin.

I never thought of myself as superstitious until I realized that the day I turn 39 weeks - the target date for a planned c/section, is Friday the 13th. Again with the odds. If I truly wasn't superstitious, I don't think I'd care...but as it stands, I might care. I haven't decided. Part of me thinks "screw it, it's just a day, probably won't be a very busy one, maybe I'll get some extra attention." But the other, very small part of me still insists "what if...." The bigger reasons I think I'll try to avoid that day are three-fold: (1) one of my co-workers said that statistically, more botched surgeries happen on a Friday than any other day, (2) even if Friday the 13th is perfectly innocuous in and of itself, the reputation of that date might make the doctors and surgeons more nervous or distracted, even subconsciously, so indirectly, it would be a bad day to go under the knife, and (3) do I really want my kid to have a friday the 13th birthday for his whole life? I know it won't always fall on a Friday, but still.

I think I will use my hesitancy as an excuse to make it a few days earlier. My dr is really going to think I'm a nutjob now.

My baby shower was yesterday. It was pretty fun. I really tried to let go and enjoy it and I did. Exhausting though, I was standing for most of the event. And thanks to my SIL expanding the invite list almost 3-fold, presents took a ridiculous amount of time. A few people had to leave in the middle, it was kind of embarrasing. And there weren't enough games. I love games at these things.

I got some great things - most of the essentials on my registry plus some things I didn't know I needed. It's not like a wedding registry where you know you're going to need a matching plate set at some point and you know you could really use that fancy mixer or serving platter. I have no idea what I need. I was trying to register for bottles last minute and was kind of bewildered by the 7 pages of choices. I eventually gave up. There was a bottle in the middle of my diaper cake I can use I guess. I asked a colleague about this most impossible of choices and she said babies can be really picky anyway so don't go nuts on a whole set, try a couple out, see what they take to. That's kind of been my theme for registering and shopping. Don't go overboard. It's so easy to think you need all the stuff they sell. But you don't. I plan to figure it out as I go as much as possible, rather than over-spending now.

That said, I am now the proud owner of a swing, a p@ck n' pl@y, a d!aper genie, a really nice car seat, more outfits for a 0-9 month old than there are days in 9 months, a baby tub, an exersaucer, blankets, swaddlers, baby toys and books, more decorations for the nursery than I can possibly fit in there (including TWO jungle animal mobiles)...it's overwhelming. I'm not totally sure what to do with it all. I am feeling serious pressure to get everything completely ready before he arrives because of the likelihood of surgery. I will not be able to do many last-minute decorations and cleaning and shopping when I'm in my first few days of recovery. But I still have not been able to bring myself to clip tags and do loads of laundry. I haven't been able to click "confirm order" on my almost $300 breast pump. I keep imagining how it would feel to have the nursery perfect for the arrival of a tiny person, to have his clothes folded neatly in their drawers and his toys opened and organized on their shelves, his swing assembled, his diapers stocked, only to arrive back from the hospital empty handed. I know it's normal to worry a little about this and at the same time, not normal to let it consume you. And people keep telling me I will always worry about something, like this is just some run-of-the-mill anxiety. But this isn't. This is the biggest fear I've ever had, the longest waiting period to resolution, and the most important stakes imaginable. This is not "normal" fear but it's also not "normal depression," and I am looking forward to being on the other side.

One of DH's cousins has had two children and in the course of birthing them, has somehow acquired every birth story known to woman. Medicated and not, c/section and not, interestingly, both of her kids were breech - she tried the version with both, it worked with the first and not the second. She was encouraging me to try it. She said the doctors are very good at taking into account the well-being of mother and baby and for her it was the best choice because her c/section recovery wore on for 6 weeks. She did add the qualifier that she's always been "slow to heal" from things, physically speaking. Weird. And she was around 40 at the time of her c/section. I appreciated her sharing her experience and reassuring me of how common breech is, but I still think the version is not for me.

Genetic counseling

I spoke with a genetics counselor today. I can't say it allayed all my fears, but it did provide that invaluable second opinion - or rather first opinion from someone that actually knows about this stuff.

Starting with the CPC, my OBG has said that the CPC maybe increases my risk by, for example a factor of 1.5. Another time she said it might be increased from 1/100,000 to 1 in 70,000. And she said based on this she doesn't think my risk rises even close to the amnio risk and thus that I shouldn't get an amnio. The numbers I've seen on the internet suggest a CPC increases your risk by more like a factor of 7-9. The genetics counselor said to use a factor of 10. Score one for Dr. Google. This means that my "less than 1/100,000" which, incidentally I was just informed is the lowest you can get at their facility (which is where I had my first tri screening calculated), turns into "less than 1/10,000....or lower [she added, taking into account that if I was at a more sensitive facility my risk might have been even lower than 1/100,000]" Still lower than the general population. About the same as my age-alone risk for having a live T18 birth.

She didn't comment to much on the breech situation because she said it's considered more of an obstetrics issue. She said that they do not change your risk numbers for trisomies based on breech presentation. It's not a marker. It doesn't increase my risk. That was nice to hear. I tend to believe it when I read that babies with chromosomal problems are breech with a little more frequency than the general population, but it was around this point that she asked if I had been reading the internet. I took this as a good sign that I was getting into 'crazy' territory and should try journeying back to reality. I told her that the numbers I had read for breech in the general population at term were around 2-3%. She said that sounded low to her. She thinks it's higher.

So that's the good. The bad is that it sounds like the second tri quad screening could have added some value. I'd feel a lot better if I'd had those results to back up my first screening, but I still think, based on my research, that the second tri screening is less reliable in picking up T18 and more susceptible to false positives so I'm not beating myself up over not having gotten it.

The other bad was when she said sometimes they do get a baby with just a CPC and NO other findings and it ends up having T18. It happens. I know this. I asked with misguided hope whether there have been babies with extremely low risk screenings like mine and a CPC and T18 and she answered the same way - i.e. what she meant by "no other markers" is no other indication on any screenings or scans that anything was wrong. So it could happen in my case. 1 in 10,000 though, right? She didn't really have an answer as to whether I could take comfort in how well he seems to be progressing at this stage - I think she works mainly in the land of 12-24 weeks -- prime diagnostic territory, she works in CVS and amnio land, by 36 weeks most patients that are sent to peri's have resolved whether they have the problem or not and they stop counting markers.

She asked whether anyone had offered me an amnio back at 19w. Here it comes I thought, a whole new attitude towards amnios over here in high-risk land. I said "first they didn't call me with the results of the ultrasound until the quad screen window closed and then they recommended strongly against an amnio." And I named names. The geneticist said she respected my obg and thinks she's good, which was nice to hear, but also mentioned that while some people look at cold hard numbers when deciding whether to do an amnio, some need it for peace of mind and reassurance regardless of what the numbers say. And it's true, of course, some people have amnios with NO risk factors at all. I do wish I knew for sure that he was ok, but that's fantasy land. Not only can we not see the future, but we don't get to have it work out the way we want it either. And I do not regret not getting an amnio. Given my low risk numbers (and that's what this woman classified me as - "low-risk" for T18) I could not justify putting the baby at risk. And I don't feel any differently now.

She asked if my husband was worried about any of this - another signal that I was crossing into crazy paranoid first-time-mom territory, or maybe she was hinting that my litany of questions and fears were so irrational that they must have been driven by someone else. Nope, just my overactive anxiety which gets kind of out of control when I have four months to google. I said no, he wasn't worried. I still maintain that he's not as worried because he doesn't understand T18. It's really sad. REALLY sad. I have this hunch that if he knew more about it he'd be more concerned. But I wouldn't wish my anxiety on anyone so I've spared him the details.

She finished the conversation by saying that she could look into getting me an ultrasound or even an amnio if I wanted it. She sounded very energetic about this which I wished she hadn't. This is where I wished she would act more like my obg - like, you can do it if you want but I really don't see the point. But I have to realize that the peri's and geneticists get paid when I come in, and these ultrasounds and amnio's are what they do. That's the whole enchilada pretty much. Of course she'd offer. She said she hoped I hadn't been worried about this since 19 weeks and I admitted it's been pretty bad. I said I'd call if I wanted to pursue this further but that given the breech situation I may be 2-3 weeks out from the birth and it seemed a little late. She then mentioned that unless the baby had visible problems at birth, difficulty breathing, etc. they probably wouldn't pursue this further. I think she was trying to sell the amnio or additional ultrasounds, but it really just confirmed what I expected - no one is treating my risk factors as high-risk. No one will without more information. And I think I'm ok leaving it at that for now.

Update on peri appointment

My obg called and said a consult with the perinatologists would be covered. A follow-up ultrasound would not be. I wish she had left it at that. THAT's what I wanted, I quickly realized. To talk to people that know without the opportunity to find additional markers or some other issue. I'd probably freak out over something as minor as the baby measuring a few days behind at this point. It was kind of a relief that an ultrasound wouldn't be covered. Why didn't I think of this before? Actually I had, I was just to chicken to admit that I was too scared to have another ultrasound and just wanted a second, more expert opinion on my risk because I have trust issues with my obg.

But then my obg said something kind of tactless. She explained that no kind of follow up would have been covered if the CPC was the only flag that had been raised. But now that there was an "additional finding," i.e. the breech, the consult would be covered. I really didn't want the breech to be ever classified as an "additional finding." In fact I think I would have preferred for insurance not to cover this at all. I would have found some relief if they'd said "don't be ridiculous Astrid, you cannot direct your own medical protocol, if there are no indications for follow up, you don't get any follow up, and breech is not an indication." But now it's enough I guess... I think my obg has had to do some major convincing that I am freaking out and that the consult is for peace of mind, and I know that plenty of CPC-only follow up is covered, so I shouldn't be alarmed that they're letting me do this visit after all this pushing. But still, if there's something to worry about, I will worry about it. I prefer to think of it as: given the "additional finding" they can understand why I'd need to talk to someone but they refuse to do an u/s on the basis that there is most likely nothing to be found and thus nothing to worry about.

In any case, this has settled my decision, I am going to do the consult. They'll probably give me some cold-hard statistics, may review my first u/s, may adjust my risk numbers in some arbitrary way. But at least whatever they say will be coming from people that know.

Thirty Five Weeks

I spent all week wearing even looser clothes, doing pelvic tilts and poses with my butt up in the air, trying to get my ute as far away from my body as possible, trying to get the LO to tuck his head under and turn around. I paid close attention to where I was feeling hiccups (consistently in my crotch) and where the heartbeat was clearest (right above the pelvic bone, every time). I was sure these were signs that he'd turned head-down. That last week was just a fluke. That we'd just caught him on a particularly playful day.

"Did he move?" My obg asked, right when she came in.

Just that should have been enough to crush my hope. I didn't know it at the time but it became clear later that she was suggesting that it would have been obvious if he had moved. "I don't know," I said naively, "he's been moving, I've been doing the exercises, but I still feel a suspicious bulge where his head was last week, so I don't know." She frowned at that.

She got the u/s out and the baby is still head up. I am now convinced that he's been that way for a while and that my obg was wrong when she thought she felt his head down where it was supposed to be at 30 and 32 weeks. Everything I've felt for the last week, every bulge and kick and hiccup, the way my ribs get sore when I sleep on my right side (because his head is resting on them), has been exactly the way it's been for at least a month, maybe two - ever since I could really feel him up in my ribs and feel stationary bulges that represent his head or butt. He's not 'still just moving around' as I had hoped. He's just stubbornly breech.

My obg said: "keep doing those pelvic tilts! you gotta believe!"

I don't believe. I'd love to be pleasantly surprised, but at almost 36 weeks it would take a monumental shift for him to get into proper position. I know it's possible and happens all the time, and I know babies have this instinct, but I'm just saying, the way things usually work out for me is that I end up in that 1-2% and I don't know why this would be any different. At this point I've sort of given up in a lot of ways. I feel kind of numb. Powerless. In a 'whatever will be will be' sort of way but without the optimism. Hope yes. Hope that he will be healthy. That's all I care about. I don't care about an impending c-section, I don't care what they do to me. I just want to hear my baby cry whenever and however he emerges and to hold him in my arms and take him home to start our new lives together as a family.

My obg pointed out that my baby was swallowing fluid and we watched a few hiccups. She remarked that these were healthy neurological functions. This is the very first time she has even made an attempt to put my mind at ease about my baby with a concrete example of well-being. This is the first time she noted one of his characteristics and said - see that? That suggests he's healthy. And I appreciated it. But he had his little fist closed throughout the scan, which was only a couple minutes. For some reason I think I could let go of all of this if I had just seen that little hand open. I asked her if she could tell if the cyst had resolved. She checked out his brain and said she thought so. But I have SO run out of trust in her, I don't know why I even asked. I have this gut feeling that she has no idea.

My obg, who, may I remind you, told me last week that she'd "be there" for me "every step of the way" as I was breaking down in tears over the breech finding, is not only not going to "be there" for me throughout the month of August but is also not going to be there next week. So I asked which Dr's would be there next week and I got one that I don't think I will like very much per my obg's assistant's remarks. Next week seems kind of important. I'd expect we'd need to actually schedule the c-section around then. It would be nice to have some assurance that she will at least see that that happens. It's kind of scary when you know the safest way to deliver is by c-section. There goes the option of delivering in an elevator or a car - I mean of course those are not ideal but women have done it in a bind. Scary to think that I'm now on the surgeon's clock. I know I know people deliver breech babies vaginally, and some would argue it's just as safe as a c/s, but based on what I know, which is admittedly little, I am not convinced and definitely wouldn't want to risk it.

I also asked my obg who she'd recommend for the c-section since she won't "be there" for that and she went off about one of the doctors who started off as her intern and who she's been friends with for umpteen thousand years and how they practically grew up together and she finished with some inane remark like "if I had to pick one from the heart, it would be her!" To be clear, I had asked her which dr. is the best at c-sections...and she gives me some drawn-out answer about who her bosom buddy is? Fail. Not picking that one. I'll ask the new dr. next week.

I do now have the option of going to see a peri. I thought if he was still in breech today I'd probably go. But now, since he is still in breech, it looks like I may get to meet him sooner rather than later and the whole idea of getting worked up over this appointment (I'm sure I'd be nervous about it) and having them not be able to tell me anything for sure doesn't sound so great. Plus, I'm not sure my insurance would cover it and a u/s w/ a peri is not going to be cheap. It would be great to have some peace of mind for the last few weeks, but again I run into this risk that there will be more to worry about. I think I'll find out if it's covered and go from there.

So I'm bummed out. My shower is this weekend and I'm looking forward to that being over. I'm sure I will enjoy the party and I'll have someone using my camera to take pictures and one day I might look back on it with fondness, but for now I'm just going through the motions. I don't even know what I'll do with all the stuff. I'm pretty sure it will seem foreign to me, like - what will I ever need this for, what silly presents! But I am looking at the positives. This baby is alive and kicking and seems healthy and this far along, you'd think we'd know if something as bad as T18 were wrong. Maybe not know know, but wouldn't there be more signs? I mean more than the breech thing? And he is my little guy, and this shower is about him. It's a celebration of him and no one knows the future, every single person is operating on faith. I need to accept that and enjoy it for what it is. I need to stop waiting until the perfect future is laid out in front of me and guaranteed. I need to stop postponing enjoyment.

Oh and my obg didn't tell me my fundal height today. And I didn't ask. I don't know what that means (the fact that she didn't tell me), but I kind of don't want to know anymore. Which maybe should indicate to me that I don't need that peri appointment. I can't even take a fundal height reading.

Thirty Four Weeks

The hits just keep on coming but I'm experiencing a strong moment so I thought I'd update. I had my 34 week appointment yesterday. I raised the CPC again w/ my OBG for the first time in months. Because it's getting to me so much lately I figured it wouldn't hurt to ask what I could do for reassurance at this point. I half expected her to recommend I start z0!oft immediately. And I don't think I'd say no. She reminded me again that "it happens all the time," and reminded me about my 1:100,000 odds. She said she didn't know anyone who would do a genetic amnio this late (interesting...is there a different procedure for genetic amnios than for lung-development amnios that would make it more difficult to do the former at this point? Or are they the same but high-risk such that no one would bother with a genetic this close to meeting the baby?). She reminded me that if I went to see a peri it would be out of pocket because the insurance company thinks so little of my risk that they wouldn't pay for it (they'd rather take the risk of having to pay later - is how she explained it, i.e. the risk that the baby will have something wrong with it and have a lot of medical expenses. Cold. hard. advice.) Fine, I thought. Commence trying to live with it for another month +.



Fundal height 34 at 34. Exhale. Perfect.



Then she felt around for the head. It's never the thing you're most worried about. I've never been worried about his position, he's been so consistent. Since 19 weeks. Head. Down. Really low, in fact. So she felt down low where she usually finds it and said, "that better be the head. I'm going to get the scanner." My heart sank and I felt frozen, the panic and tears welling up. I knew he was breech in that moment. There is no way she'd get the scanner unless she was pretty darn sure.

She brought out the u/s machine and flipped off the lights while I tried to compose myself. I have not had the best experiences with these scans. Although I am thankful that they are so readily available in that office. There was his head, right under my rib cage. "Little devil!" She said.

His position is one of those things I've been vigilantly watching in order to reassure myself that the baby is choromosomally healthy. There are precious few things I can look to...Fundal height is perfect, he's been head down this whole time, movement - fine. Must be healthy, push that CPC as far back in your mind as you can.

Now he's in breech. At 34.5 weeks. Up go the odds of choromosomal abnormalities again. I asked what could have caused this, trying to get her to comment on a choromosomal link without giving away that I have done my own research. She looked at me like I had just hit her puppy, hard. She took the defensive immediately. I had dared to suggest that she wasn't telling me something. "This just happens, nothing causes it." She said. "Isn't it associated with choromosomal abnormalities?" I asked. "It can be," she admitted, looking like I hit her puppy a second time. Why would I drive that stake in deeper, her face seemed to say. I was just asking. I still don't know why she gets so threatened by an informed patient.

I know breech happens all the time. And I know it can straighten itself out, and does pretty often by 36 weeks. And I know it's not really a 'marker' for any of the trisomies. The rational part of me is reminding myself that this is 'normal' most babies are breech at some point, for all we know he's back head-down again already. He was head down for soooo long, this has to be a temporary blip. He knows where the exit is, his neurons are fine, this has to be the result of me being in a bad position for a while or drinking too much or not enough water or of him just having a burst of energy and getting himself into a pickle.

But the other part of me fixates on statistics like 5-10% of breech babies have something congenitally or choromosomally wrong with them. My thoughts flash back to those few stories of "isolated" CPCs that did end in tragedy. They all start off the same, isolated CPC, nothing else abnormal, doctor said not to worry. No one even bothered to do any follow up. Then, mid third trimester other signs started popping up, still the doctors said not to worry. Excess fluid, size drops off a little, breech position. No worries, it can all be attributed to normal harmless things.

This was a pattern my OBG followed to the T. She thought it was ridiculous for me to be so upset (I was crying at one point). She accused me of not being able to cope if everything didn't go textbook perfectly in my pregnancy. And maybe that's right, maybe I'm overreacting to tiny imperfections and that many, many pregnancies just 'get messy' by the end, but when I get two signs pointing to choromosomal problems (which are easy to miss if you don't do diagnostic testing), I don't think it's so irrational for me to get upset. It's not like I have previa and breech. Or GD and preeclampsia. Unrelated complications that can be managed. Or related complications with an easy fix or at least a not-so-dire outcome. The 'imperfections' I've had come up have both pointed to the possibility of something being wrong with the health of my baby. Above all things I don't want him to suffer. Why is she sweeping my concerns under the rug again? She mentioned the various other things I should be worried about at this stage which are WAAAY more likely, as she put it. PTL, she said, and a few others - none of them particularly scary - she just wanted to give me some perspective, not freak me out more. I don't know why I had to explain to her that none of the things she mentioned, while maybe more common, had an outcome that even came close to having a t18 baby (e.g. PTL at almost 35 weeks, while bad, is not typically as bad as 'incompatible with life'). The equation for risk, if I remember correctly from college, is: likelyhood times magnitude of the outcome (or "impact"). While the likelihood of T18 may be small, the magnitude of the result is such that it still results in a pretty high number. And that's what I internalize. Said that way, it almost scares me how rational I sound.

I've lost my will to google, it seems too real now, too big of a risk. Too close to knowing for sure. I am NOT going to go looking for what kind of breech T18 babies are typically in and for how long. I am not going to look up stats on soft markers + breech. I don't want to know. Before this experience I thought knowledge was power. Now I know it's paranoia.


After the scan my OBG handed me a xerox of an exercise I could do to get the baby to turn. She then started telling me about my options if he doesn't. They are two-fold:

1. External version: The obg hooks you up to all the monitors at L&D and tries to flip the baby manually. Thing is, this procedure is fraught with risks. Placental abruption, cord prolapse, fetal distress, ruptured membranes. That's why you have to be at L&D, in case an emergency c-section is necessary. I read a post on B@byc3nter about a woman who lost a baby doing this. Oh plus, it apparently can hurt like a mother-effer and has a higher rate of success if the woman has an epidural before hand. Probably because she won't be writhing in pain and getting in the way of the dr's manipulation. I am not doing that s--- twice (the epi). AND it only has about a 50/50 shot at working. Some stats I've seen say as low as 30% successful.

2. Scheduled c-section. This I am ok with. I've always been ok with this idea. I know, I know, major surgery, plenty of risks, too posh to push accusations. But I wouldn't mind some certainty in my life these days and neither DH nor I are objecting to the idea of getting this baby into the world as early as is safely possible.

I've tried the exercises and I'm skeptical. If babies are supposed to know which way is down, why do we try to trick them with inversion poses? If we're trying to encourage their 'natural decent' wouldn't turning upside-down confuse them further? And if they really are confused and the whole point is to trick them into thinking down is up, is 10 minutes twice a day really going to fool them? My OBG said the prop-your-butt-10-inches-into-the-air "exercise" works for 50% of women. Doing my own research I found out that there are no studies suggesting that any of these exercises makes any difference. I also learned that between 34 weeks and term about 50% of breech babies turn head down anyway. This makes sense to me. Common sense. The baby is going to turn, or it's not. 10 minutes twice a day or not. And don't get me started about putting an ice pack on my baby's head (not going to happen) or the idea of playing music or shining flashlights to 'attract' the baby downwards. What if those things are bothersome to the baby?

The more helpful suggestions I've heard seem to be guided by common sense and are aimed at creating more room in your abdomen and pelvis for the baby to move - that is the big problem at this stage, room is running out: rocking on all fours, sitting on a birthing ball with your legs a fair distance apart. I've tried sitting up with my legs in the butterfly position while watching TV and putting an extra pillow between my legs at night to open it up down there. Drinking extra water all the while. I think he knows where to go, he was there for a while. And I guess there's still time.

Try as I might, I cannot tell from day to day where he is, if he's head down again. I guess I knew before the appointment that he was moving in different quadrants of my womb than he normally did, but I couldn't tell that he was in breech. I rarely felt him on the left side until the day or so before my appointment. It started to get pretty uncomfortable and I just figured he was getting bigger. Filling out my whole belly now. I dared to hope there was a good reason for it. And now I do as many checks as I can, but still can't tell what's going on. I feel hiccups right at the bottom of my pelvis, just like I always had. I thought that suggested head-down. I went looking for his heartbeat last night and when I got super-low near my pelvic bone is when I heard it the clearest. I thought these signs meant something, and maybe he's flipped again. But I'm having trouble trusting the signs now. Because if they are reliable, then he must have been in breech for an awfully short time. And if they're not, maybe he's been that way for a while.

The silver lining is that now I'm getting weekly appointments and will probably get another u/s or two in to check position. Unfortunately she didn't dwell long enough the first time for me to get a glimpse of an open hand or anything else reassuring. There's still time though.

I did call the peri. My obg gave me the name of someone I should talk to - not because she thought it was necessary, just because she knew I wouldn't be able to stop worrying - so I called to start the process. I called too soon the first time, my obg hadn't faxed the appropriate referral or whatever so I called back today and had to leave a message. I'm not sure what I'd be trying to achieve with a peri appointment. My obg assured me that there was nothing an u/s could do at this point to rule out t18 or reassure me - I don't know if I believe that. I'd love to see that hand or even just hear that the growth is on track, the fluid even. Throw me a bone here. Five+ weeks is a long time to live with this. For me. I think I need a specialist to tell me what the risks are, to give me some perspective, to review my initial anatomy scan or to look at the baby now. Maybe to tell me something like - T18 babies are sometimes breech because they're small or their fluid is too high, neither of which is the case for you. ANYTHING.

Or maybe he'll go back. In which case I may not go through with the appointment. Because the appointment has potential for downside too. I may hear something I don't want to hear. For this reason, even if I do go through with the appointment, I think I will schedule it for after my shower on the 25th. I don't know how I'm going to get through that day even now, if I had additional bad news or fears by that point, I don't think I could do it. And cancelling would mean alienating every friend and family member that I'm close to and some that I'm not. Seriously this event is going to be on the scale of my wedding. It's not what I wanted. But none of this has been how I wanted. Except the being able to get pregnant part, which I do not take for granted. That's life I guess. So I don't really have any choice but to weather through it. A day at a time.

Same old stuff

Disclaimer. I'm beginning to sound like a broken record. Ok, still sounding like a broken record. If you're tired of hearing it about how pre-partum depressed I am and the same tired reasons, don't feel like you have to read. I'm questioning the wisdom of continuing to blog in these last weeks because it's become clear to me that my fears are entrenched and my mood isn't changing.

I'm still in a four-month funk. Smack dab in the middle I guess. I still feel a little distanced from the pregnancy. Everything seems on track. Everything seems fine. No one is worried about my baby except me. But still, the funk persists. I feel like I did when I was approaching the NT scan. So nervous that it was making me upset. So upset that I had to just forget that I was pregnant for a while. Little harder to do now with the LO kicking and squirming and my baby shower on the horizon and everyone's well-wishes and comments and stories. I am clearly a pregnant person now. Visually. Physically. There's a baby in there. I can feel him. I know about where his arms and legs are. I can identify limbs by where I'm getting socked. I can even feel his little feet through layers of belly. It's amazing. It thrills me. But I can't let go.

This week when a work acquaintance that I hadn't seen in over a year asked me (not wanting to be too forward) "what's new?" I talked about how hot it's getting. Not about the baby. What's wrong with me? I haven't put a single post up about my pregnancy on FB. I could say it's because I'm trying to be sensitive, but the truth is I'm just scared. Scared to count my chickens.

I just had my 32-week appointment. Fundal height is 32. Baby's head is down. Heartbeat sounded slower to me, w/ no accelerations, but sounded fine to the OBG. We didn't listen very long. The baby was being pretty quiet and I know the hb slows as the pregnancy progresses. The kid won't have a rate of 150 his whole life. But every time she says something's fine I have flashbacks to a year ago when she was telling me that my elevated HCG of 44 several months post-miscarriage must be the result of a second pregnancy. When the level was still 44 two days later she was convinced we had caught the hormone levels at 44 going up and then again at 44 going back down two days later. A second failed pregnancy, she concluded. Now I understand that when you hear hoofbeats you should look for horses and not zebras. But when you're on safari and you hear hoofbeats and then you see stripes, and then you conclude that somone must have painted stripes on their horses, you are delusional. I'm worried about the lengths she goes to to convince me that everything is fine. I want to believe her and everyone else telling me not to worry. I can't.

Instead I make desperate attemtps to control the other aspects of my life and my pregnancy making myself and everyone around me somewhat miserable. Example: my parents made me a sandwhich with lettuce from their garden the other day. I wouldn't eat it, I found the tinyest speck of dirt after a careful examination and concluded that if I took a bite I'd be fretting about toxoplasmosis for the next two months. Another example: I had been planning a mani/pedi trip with some girlfriends - I had been looking forward to it for ages and I was the one making all the arrangements. And a couple days before the trip one of my friends asked, in all innocence and sensitivity, are you sure you want to go? Implying that I might be concerned about fumes or something. I went from super excited to hopelessly fixated on the tiny possibilities that something could go wrong - bacteria, infection...PTL, fetal demise, I couldn't stop my brain from going there. And even though I've had two pedi's during this pregnancy I suddenly couldn't cope with the idea of going. At the last minute I made up some excuse about having to work. This is depression. Paranoia. Anxiety. I'm pretty sure I'm a good candidate for a 'peace-of-mind' amnio or anti-anxiety meds. But I'm so close. I'm going to suffer through. And if I get a chance to hold a healthy baby in my arms I will know it was all worth it.

I keep telling myself that we'd know something by now. If something serious was wrong, there would be signs by now. We've come so far and everything is SO on track. But then I realize that's how it goes in a lot of tragic stories. There is always a tragic story to match my experience. I go on google sometimes just to get a 'fix' of reassurance. There are so many good stories out there. But there are some bad ones too and sometimes I get bitten in the a$$. I'm kind of over it though, it's getting so close and so real that no one else's stories are going to matter soon. Because I will know the ending to my own. I won't have to rely on statistics or signs. I will know.

It's hard to keep up the charade of bliss. It really feels like I'm pretending when I'm talking about daycare options or things I'm planning to buy for the baby. My SIL is making my shower quite the event and it makes my stomach turn a little. She's having her husband hang awnings on the house! ??? And she and my mom have been out shopping a couple times just for decorations, favors, etc. They are so excited. I wish I was. This is all I ever wanted. But at the heart of it, I want my baby to be healthy.

The bigger he gets and the closer I get to meeting him, the more practical I've become. He is my baby. No matter what. I love him. And I will take care of him. What scares me is the thought of losing a baby, watching my baby suffer, and what that would mean for my life. My marriage. My family. It happens.

I try to tell myself that I'm worried about nothing. An infinitesimal chance. Try to tell myself that some people without a CPC on their baby have a higher chance that theirs will have T18 than I do, just by virtue of their age or because their screening results didn't turn out quite as perfectly as mine did. I try to tell myself that no one has a guarantee, not me and not the women who are enjoying their pregnancies and their showers and decorating their nurseries. I try to tell myself that I'd be worried even absent the CPC. Worried yes. Depressed no. I'm a different person than I would be if I knew all was fine. If the biggest things I had to worry about were labor pain, not eating raw cheese and avoiding car accidents.

In other interesting news, my OBG, the one whose piss-poor handling of my miscarriage and GTD has haunted me for a year, that I haven't managed to break free from, is going to be gone for three weeks in august. Sabbatical. Chances are that she won't deliver me (score). AND, it also means that I'll be getting a different obg for those weekly appointments leading up to the birth. Which means a second opinion on just about anything I want to ask about (ahem, CPC). Losing your OBG at the end stages and having an unknown in that role would probably terrify most women. I, on the other hand, am thrilled.

Thirty Weeks

How far along? 30w6d



Maternity clothes? Yes. I went shopping like I promised last weekend and came back with a couple T-shirts, a dress for the shower (and an upcoming work bbq) and a new handbag. Doesn't a handbag count as maternitywear? I don't care, I needed the retail therapy. It's a longchamp bag. The last handbag I'll ever need. I know this because I have a smaller bag made from the same leather, it's treated such that it won't scratch, it's waterproof, and it doesn't look 'treated' - it just looks sleek. It's a day-to-night bag and holds everything I need, even the occasional water bottle or book, without looking too huge. And it's probably the last purchase I'll make for myself for a loooong while (although I'm already thinking of getting the PX90 system for after delivery...anyone have any advice on that? Anything from "get it it's the best decision you'll ever make" to "forget it you moron, don't you know you won't even have an hour a day to yourself post-baby?")



Stretch marks? Belly is still clear. It's really starting to stretch though, I hope it stays this way. It's one of the last things I care about, really, but I wouldn't mind getting through this with my belly unscathed.

Bellybutton: Still goes in.


Sleep? I can still sleep! Oh and I do. And I'm starting to feel really tired lately. Like first-tri tired. The only thing keeping me from getting as much as I want is work and TV - has nothing to do with pregnancy. There are so many good shows on right now. E.g. so you think you can dance, hell's kitchen, kourtney and khloe take miami, I have a backup of glee episodes on my dvr, I'm a chelsea lately addict...I can't get enough of TV. I keep thinking TV is all I want during labor and I will never get bored spending all that time in the house during maternity leave.


Best moment this week? I had a good (read: uneventful) dr's appointment which was nice - baby is head-down (which I knew already because I've been feeling hiccups in my a$$ basically - sorry if TMI). I read some CPC post from a girl who said she was sent to the mayo clinic and that the mayo clinic's latest position on CPCs are that they don't increase your chances of trisomy with no other signs (so yes, I've still been googling, but I stopped after that one - quit while you're ahead, right?). But I think the BEST moments have been the ridiculously strong kicks I'm getting - to the ribs, to the guts, I don't care, it thrills me. It's starting to feel like an earthquake in there, like he's trying to get out through the side. Doesn't happen with that kind of strength all that often, maybe once a day or every other day, but man am I impressed by this little guy's forcefulness. It's really reassuring.

Worst moment? I hate how freaked out I am by my poor furbaby now with her bark collar. I make DH handle it as often as possible, I don't want to even be around it when it's on and when I know I'm going to get home before him and have to take the collar off, I worry a lot about how I'm going to do it without hurting myself again. The dog is a complete nutcase when we get home, very chaotic, jumping and yelping, and it's easy in that setting for the thing to go off accidentally. I'm downright phobic of it now and I really don't need that extra stress.

Movement? Still on days and off. But like I said, getting stronger. Sometimes it hurts, sometimes it keeps me awake, and I love every minute of it.

Food cravings? Sweets. Fruit. I find I need more and more water every day.

Gender? Boy.

What I miss? Not being so paranoid.

What I look forward to: meeting my baby.

Pre-Baby To-Do list: We crossed off "find a pediatrician." Now on the list are things like survive the shower, finish the nursery (pretty much just need to assemble the bureau and hang a quilt, everything else is done!), four days of baby/birth classes, and there will be some mad-dash shopping after the shower for sure since we're only leaving about 4 weeks between the shower and the due date and probably won't buy a thing before hand.

Milestones: We went to our first baby class - it was infant emergencies and CPR. It was taught by an older guy who has been a paramedic for decades and it was pretty hard to hear all the horrible stuff that can happen. What a life that guy must have lead so far - all the things he must've seen. I thought the class was very helpful. Sure there was a lot of common sensiness, but also a lot of things that I wouldn't have thought of, plus the essential skills like CPR and baby heimlich.

Emotions: I am a complete and utter emotional mess. This week I've come home from work crying, and cried myself to sleep twice. I've cried at radio commercials and TV. There are a lot of factors here. Work has been awful - not only too busy, but also one of those weeks where you realize you just can't be friends with a superior - can't trust them, need to realize they don't care about you, etc. I was treated horribly this week, with disrespect and broken deals and just felt walked all over and used and unappreciated by one of the partners whom I most trust, despite doing extremely good work on an impossibly tight schedule AND going beyond 'above and beyond.' I also got in a fight with my mom which didn't help. And of course, everything is made so much more fragile by my fear about the baby's health. I keep thinking I will be a new person once he arrives safe and sound. And not just in the usual "i'm a new parent" sense. More in a "my brain is better balanced, chemically, now with markedly decreased stress hormones." I know all you nay-sayers thinking "Astrid, you have no idea, the stress hasn't even begun." But I am not your average worrier. And as I've said before, I am confident that what I will feel post-partum will be more relief than anything else if this baby is as healthy as he seems. I keep thinking of all the things I will be able to do without a second thought. Eat a tomato from our garden (worried about toxoplasmosis now), not compulsively scrub the cutting board and knives for fear that DH's deli meat residue is all over the place, handle the shock collar, not feel the need to compuslively wash my hands or never use the same dish towel twice, not be kept awake by the idea of the dogs stepping on me in the middle of the night, not be so afraid, and not wake up every single morning with the CPC on my mind. I thought I appreciated the idea of a healthy baby after suffering a traumatic loss, but I had no idea. Just as the hell of infertility and loss makes you appreciate pregnancy more, a scare during pregnancy followed by a positive outcome would undoubtedly make me an even more appreciative parent, if that's possible.

My trip to L&D

First, don't worry. No emergency here.


I called my OBG the day after the whole shock collar episode just to let her in on the news. I LOVE second opinions, love to know whether I'm getting some doctor's random conclusion on a matter they've never really thought about, let alone studied, or an actual tried-and-true medical assessment. The way the on-call doctor brushed off the collar shock by saying "it's safe for a dog so....no big deal" kind of ate away at me. Safe for a dog so safe for a tiny fetus heart? Really? I don't know. Still I wasn't that worried (thank you #2billion75 to the doppler) but in true form, wanted to just make sure the advice was consistent and thought my OBG should be aware of what happened anyway. So I left a message for my OBG about what happened. Before she hung up, the receptionist asked the typical "is fetal movement normal?" My response: "well, he's definitely moving, but less so today [the day after the shock] than yesterday." This was true. He was moving waaay less for about 48 hours after the shock. He has quiet days. But this was two quiet days in a row... Still, I wasn't that worried. But that comment about 'not moving as much today' was enough for the OBG to send me to L&D for monitoring.





This is one of those times that made me simultaneously glad she was taking a concern of mine seriously and also worried that maybe there was a reason to be concerned. When she called me she gave me her usual analysis - every time I ask a question the answer either depends on (A) what the American college of OBGs has to say on the matter or (B) how many studies there have been on the subject. This time the comment was "there just aren't any studies on this." She said she doubted it was a big deal but that if I noticed less movement, she just wanted to be sure everything was ok. I did too so I was fine with the plan. And stupidly, I had done some googling in the meantime (it's a disease) and noticed that electric shocks can gravely affect fetuses depending on things like voltage and duration and path of the current through the mother's body - even if the mother isn't affected all that much. Sad, scary studies. So there were studies but not on bark collars. I couldn't even figure out how many volts were in the dog collar, it's probably a PR thing for the e-collar industry. Doesn't look good for a company to talk about peoples' dogs in terms of "voltage applied" probably so they keep the information hidden. I did find plenty of anti e-collar propaganda swearing that the collars had something like 7500 volts but even if that were true I think the actual voltage applied is more like 5-25. Whatever. I think it's like alcohol during pregnancy - there's no minimum that's been proven safe. Obviously it's ok and probably unavoidable to withstand some static electricity when touching a door handle or your car or doing laundry. It's like that 'unavoidable' glass of wine. But more than that and you're in no man's land.



It was neat to see the place I would deliver (provided I don't end up delivering in a stalled elevator, a car, or an emergency room somewhere), I was glad to make the trip - I planned on doing a dry run anyway before 37 weeks and this way I even got my intake information completed so I won't have to worry about that when the time comes.



There were some anxious thoughts in my mind on the way over because it occurred to me that I might get an ultrasound. Would I finally be able to see that little growing body, maybe a waving hand or some thumb sucking, would they check the fluid level and would I finally be able to put my mind at ease on the T18 stuff? Or would I see something else that would haunt me until August. Worse, would they see something alarming...



No u/s. I should have known. Instead they did a non-stress test. I've never had the occasion to do one of these and didn't know anything about it but it was pleasantly non-invasive. Just some quiet time with the monitors strapped on for me to just sit with my little one and focus on no one and nothing but him. It's so rare that I get that kind of time during the day and I really love it. I look forward to that window between when we go to bed and when I actually fall asleep every night becuase it's then (and often only then) that I can focus all of my attention on what's going on in my belly.



The babe passed the NST with flying colors. They're supposed to show something like 2 heart rate accelerations in 20 minutes (or something like that - correct me if I'm wrong) and the LO did 3 in ten minutes. He was moving plenty even thought I couldn't feel a lot of it, and this was all with no 'trigger' - no juice or soda. Just little him.



He was declared fine and I was free to go. It was nice to get a little check in without the fear of something really being wrong. And since then he's really picked up in the movement department. Even his hiccups feel stronger. Next appointment I think the OBG will check for his position and man, the time does seem to be getting nearer, despite all odds. August may get here after all.

Shocked

This blog should be renamed to something like "how to drive yourself crazy in 9 months." Like one of those quickie workout plans. Step one would be worrying about all the "rules" about pregnancy. The basics, you know, like don't eat deli meat unless it's steamed (?!) and stay away from raw eggs or fish, bacteria, germs, people in general. Like to work out? Well forget lifting anything over 30lbs or getting your heart rate over 140. So basically forget working out. Don't clean the litter box, don't do any painting, make sure to wear your seatbelt just so. You can try having a glass of wine, but it's not recommended. Just the basics here.

Step 2 would be grappling with all the choices that are easy on most days but a source of grave anxiety when you're pregnant. Like the whole flu shot debate, whether or not to take that long treacherous drive, whether or not to worry about cross contamination with respect to your vegetarian sushi...

Step 3 is what I like to call having the fear of god struck into you on top of everything else. While my CPC episode is a 1 in 100 occurrence, chances are much better than that - more like 1 in 20 - that a given pregnant woman will have some mention of a serious disease or condition as a possibility during her pregnancy. Mostly these will be "false positives" of course but then there are more tests and risks of m/c associated with those tests to worry about. And it doesn't help that it's not ourselves we're putting in jeopardy, it's our baby, our child, the ONE we worked so hard for and sacrificed so much for and have so much hope for. Our everything, basically. Everything. And there are other fears along these lines that can rain down, disasters that we have no control over. Cord accidents. Ic. Placental abruption. I don't need to tell you ladies how long this list is.

Step 4: the unforeseen crises, be they real catastrophes or mostly in your head. Makes no difference to you because to you they are real crises. This is the subject of today's post.

I think it helps to start out as a worrier who has either had trouble conceiving in the first place or who has suffered loss. These kind of credentials can help catapult you through the steps with the greatest of ease. And I happen to fit the bill. In that last category I would put things like spilling foundation in your water and then drinking some before you figure out what's happened. Again, who does that?? Others might be getting the flu, falling, getting in a car accident, having a dog jump on you, getting an open wound and wondering whether it's more dangerous to apply neospor!n or to not apply it, accidentally breaking one of the rules set forth in step 1...things that you wouldn't think twice about on normal days that suddenly become life or death situations. I ran into one of these yesterday. I got shocked.

I had just gotten home from work and let the dogs in, one of whom wears one of those static correction bark collars. I hate that thing, HATE that she has to wear it, but it's one of those last ditch efforts to save her from being taken back to the area animal control. We live SO close to our neighbors and she just barks. It's the only thing that works. So I'm holding it in my hand and saying hello and all of the sudden...ZAP! out of nowhere. I've never felt one of these things before and it was a little stronger than I expected. Don't ask me why I was holding the whole unit in my hand, prongs pointed towards my fingers, YES I should have known better, but there it was. And I. FREAKED. OUT. I screamed and reflexively threw the thing on the floor with such chaotic flare that the poor dogs cowered and whimpered and ran for hiding. I could not get my computer out fast enough - first to find the number of my OBG (why I don't have the office on speed dial by now I can't tell you) and then to google obsessively while I waited for someone to answer. The office was closed so I asked for an on-call doctor. In my book, this was an emergency, no doubt about it. The on-call obg was paged and then the tears started flowing, out came the cheapie doppler (there comes a rare moment after some purchases (not many) that truly validate having made the decision and make you think "I would have paid far far more for this moment" and this was one of them). Heartbeat sounded fine. I even felt a few kicks. And had I thought about it rationally I would have realized how very far away my hand is from my uterus and how very innocuous the voltage was. But it was on the highest setting, and electricity can travel through your body, and it can kill, and the baby is so small...what if I electrocuted my baby?!....what if what if what if......

The on-call doctor called back mercifully quickly and was like "yeah, no big deal." "Ok, that's good to hear," I was fighting the shake in my voice. She said "it's a pretty low amount of electricity, they have to be safe for dogs...and you just felt it in your hand right? It's not like it was on your belly." "No, just felt it in my hand as far as I could tell. Ok, right, I know, it's totally safe, just didn't know how it would affect a baby..." "It really shouldn't, just call us if you notice any difference in movement."

Awesome answer. But for some reason it takes a lot longer for perspective to set in than for fear to take hold. It took another half hour to stem the tide of tears. I was SO distraught and still scared, maybe by the situation, maybe by my own reaction. Still scared for the baby, I felt bad for scaring the dogs, for making the one wear this awful awful collar. I had had a HORRIBLE day at work (another long story for another day). It was just a pileup of emotion, you know the kind. Where you just can't take it anymore.

UGH! I am loathe to complain about anything pregnancy-related. This post should not be construed as an "I can't effing wait for this pregnancy to be over" post. It's more a reflection on the challenges it presents (challenges gratefully faced of course). A way for me to assess how I've handled it (please let it be true that this is just "first pregnancy paranoia" like my secretary says). Or just a story someone somewhere someday may find when they're worried because they've shocked themselves with a bark collar and need reassurance.