a will, a way, and a wish
Well, we’re still here, me and this babe on board. After of week of trying to be positive but still wondering whether I would hear a heartbeat at my appointment today, I have made it to 25 weeks.
Amazing it is, truly.
Today I had an appointment with the chief Maternal Fetal Medicine specialist (aka high-risk Ob) at my hospital. At some point I’ll have to write more about the emotional aspects of this experience — e.g., how strange it is to walk into an Ob’s office and still look at the bellies as “other.” Or about how I left the “you’re pregnant” manual in the waiting room because I was convinced I wouldn’t need it after my appointment. But for now, I know some of you want to know what’s going on. So I’ll stick to the facts.
So, after wow-ing the attending nurse with my story, I met the woman who will hopefully deliver this baby. And not too soon, please. The doctor was surprisingly young-ish. While extremely confident and knowledgeable, she lacks the warmth and bedside manner of my original ob/gyn (who unfortunately lacks the technical ability to provide my care). But I’m not looking for a new best friend, really, just someone I can trust with my life (and this baby’s). She’s unfortunately not the kind of doctor who makes you feel like you’re her only patient, but she did answer all of my questions. And she has a plan.
And while I am well aware that this may not all go according to plan — whatever does? — it makes me feel better to know that I now have someone I can trust with my care.
First she reviewed some of the known risks. Apparently the placenta previa is not partial but complete, meaning it is covering the entire cervix. Normally, in a healthy uterus the previa often resolves itself as it moves and rises as the baby grows. But in my case, it probably has nowhere else to go. In fact, the previa appears to be both anterior and posterior, making movement unlikely.
I think this little one found the one lone place in my entire womb to settle in, somehow. Literally, possibly the only place it could have attached, even if it’s less than ideal.
Since I’ve had multiple uterine procedures and scarring, I would be at risk of uterine rupture if I were to go into labor. So that doubles the necessity for a planned c-section before my due date, should we make it that far. More on that in a minute.
One big concern is premature labor. There is a recurring risk of P-PROM (pre-term membrane rupture), which is what I had last time and would send me into labor. Then there are the risks associated with the previa — i.e., the cervix (aka the most vulnerable area) is now covered by the baby’s lifesource. So no jostling. No sex. No heavy lifting, no strenuous exercise.
Um, aside from lifting my toddler, only the sex thing is an issue (might have been helpful to know sooner though). I have to say I did fall a little in love with my doctor when I asked her about sex. I said, “OK, no penetration, but, um, what about orgasm?” and she replied “well, we can’t always control that!” As if! Oh to be one of those women who has an orgasm simply while driving her car or something. Most of us have to work pretty hard at it, don’t we?
Anyway. Since the cervix is nice and closed and I’ve had no spotting since about week 10, bedrest isn’t necessary yet. But she was clear that any sign of blood should be considered urgent. Even a tiny spot. Hemorrhaging could happen quickly and would be an emergency. Similarly any sign of fluid would be urgent. So I’ve been a complete freak about that, while trying not to worry until there’s reason to worry.
But seriously, as I tweeted this morning, every day I don’t want up in a pool of fluid or blood is a really good day.
Have I told you I live about an hour away from my hospital? I mean, there’s a local hospital in case of emergency, but not one I’d choose to deliver a high-risk pregnancy. Not this one. So there’s that.
Then with my scarring there’s also a high risk of the placenta embedding itself deep into the muscles (placenta accreta), making delivery and separation difficult. They will monitor for this, to the extent they can, but she did warn me that there’s a good chance that a hysterectomy may be required at birth. Sometimes they simply can’t separate it and I’ll be losing a lot of blood while they try. She told me to drastically increase my iron intake to increase my blood flow to give them something to work with. But that conversation is inevitably coming.
Honestly, my womb has caused me so much grief and anxiety, but it’s still mine. Despite all my whining, I’m not quite ready to give it up yet. And it’s blessedly busy right now, trying to prove me wrong. So if after nine years of struggle it can actually grow and sustain a real live baby? Well then, maybe it’s a fair trade. Thoughts to ponder.
Another ultrasound is scheduled for two weeks. Doc said the baby looked good in the last scan, but she wants another more detailed anatomical scan for a more complete picture of what’s going on in there. Of course they could find something more then. We’ll see.
So we’ve got a baby with a strong will and a doctor with a way. Now I’ve just got to hope and wish and pray that everything continues to go well with no more surprises.
Oh, and the original ultrasound put my due date at October 18, but if everything continues to go well, the doc says she may want to go as early as 36 weeks. Which would be September 21. Gulp.