weighing risk

Didn’t mean to leave you hanging here. A few kind souls have followed up to check if everything is OK since the incident almost two weeks ago. I’m happy to say that yes, thankfully, so far so good.

Thirty weeks yesterday and no sign of preterm labor.

I began weekly monitoring to check regular movement, heartrate, fluid levels and contractions, and everything is right where it should be. Baby is looking good, heartrate is perfect (music to my ears), amniotic levels are great (a beautiful sight to see), and no sign of spotting or contractions (thank goodness).

This baby is quite a fighter.

I’ve been growing accustomed to the idea that we could actually have a baby, a little sibling for Jaye. Like soon.

Yet I’m still so hesitant to truly believe it, to say it.

I still know how many things could go wrong.

I am trying to accept that this baby, delivered 5-6 weeks early (4 or 5 weeks from now), will need time in the NICU. Even if I can push delivery from 34 to 35 weeks, as I hope to, an ICU stay is expected. I know that babies born at 34-35 weeks tend to do well. That thought is incredibly comforting and really all that matters. Really.

Still, I have to accept the fact is that this baby may not be able to breathe or feed on its own for a while. This baby won’t get the start one would hope to give a child through precious skin contact and intimate bonding and everything else that comes in those early hours and days after birth. Nursing will be far more difficult, if possible at all. And while I am so grateful to even be in this position, these are still thoughts that persist. And that’s assuming no further complications.

Yet another part of me is somewhat relieved at the thought of an early delivery. Honestly it means less time for something to go wrong inside. First, with the placenta issues I’m dealing with, preterm labor would be a dire emergency situation. As my doctors have repeatedly said, any bleeding would warrant a 911 ambulance call, with plans to transfer me (by helicopter, if necessary) to my hospital, if possible. But there are other risks too. Even without the preterm labor risk, women in their 40s are 2-3 times more likely to have a late term stillborn baby than younger women. I think about that fact and the women I know. I think of it every time I don’t feel movement for a little while.

And I’m just talking about the risks to the baby right now. Of course there are risks to me of waiting longer, as well. With the placenta embedding into the uterine wall or beyond, my doctor doesn’t want to take risks that could make my situation any worse than it is. Already she is assembling a team of surgeons and experts to be on call, in case of further complications. As someone who has already recovered from an 8 hour pelvic surgery to correct adhesions resulting from prior procedures, let’s just say I know this is not going to be easy.

My doctor will be weighing the risks of the placenta causing even greater harm — making separation more difficult and a hysterectomy more complicated, putting me at greater risk — against the risk of delivering a preterm baby and how well the baby will do outside my womb.

I should say that in my work as an environmental advocate, I’ve never been a big fan of risk assessment, or even cost-benefit analysis. I’ve often fought for the most stringent health protections and the most precautionary approach with the least risk possible. Yet here I am, the subject of an individualized assessment of potential risk — with my own health and welfare weighed against the well-being of this most unexpected growing life inside.

So bizarre.

This situation could change by the day, by the moment, as my doctor weighs these risks. Now I’ve got weekly monitoring, with my next doctor visit and ultrasound next week. Barring any other unforeseen events, delivery is planned for either 4 or 5 weeks from today. Crazy.

~ by luna on August 10, 2011.

24 Responses to “weighing risk”

  1. So glad things are progressing right on schedule! I’ve got hope and faith that you and the babe will both be happy and healthy.

    ~Suzy xoxo

  2. Glad to hear your “gone quiet” for no emergency reason. How goes the planning for Baby Jaye and accomodations near the hospital after delivery?

  3. Still scary, but still great. Will keep sending lots of good vibes your way.

  4. I know it’s still very scary. I know there are lots of risks. But the fact that so far, everything is looking good? Well, that’s just music to my ears. I also can’t believe that we might have second children even closer in age than our first. Just the fact that it’s possible, even likely, that it could happen is incredible to me.

  5. Wow. It sounds like your doctor is way on top of every possible scenario. That must make a scary situation somewhat reassuring? I am thinking of you…and if you need anything,I’m nearby 🙂

  6. Relieved to hear that you and the baby are hanging in there, but still holding my breath for you both.

  7. Great to hear you are doing well. It is amazing how as a reader one starts to worry/wonder how you are, I don’t know you yet I truely have a sense of concern for you.

    I so hope things keep on the steady track for you!!!

    I had (IVF) twins at 35w/3d with no NICU, so I hope for the same for you and you little bean!!!

  8. I think of you often, sending soothing healthy thoughts for all of you.

  9. So glad to hear things are going well so far. I’m a new reader – sounds like I have a similar fibroid history to yours. Currently waiting for a (domestic newborn) referral.

    My sister had two healthy girls – the first at 32 weeks (3 week NICU stay) and the second at 34 (10 days in the NICU, I think?). I know she was really worried about a NICU stay with a 3 year old at home, but they were anticipating it and I think that helped a lot. She breastfed both without big issues and she’s now active in her local la leche league. I would be happy to give you her contact info if you like.

    I’ll keep my fingers crossed that everything keeps humming along like it should!

  10. I was actually getting worried then I figured out how to see if you’d tweeted, and then I exhaled 😉

  11. Glad you’re still doing OK, & crossing my fingers that it continues! Hang in there!

  12. No. You know who the fighter is? You. Can’t believe this is all going to happen soon(ish). Thanks so much for the update, I think of you all the time. Much love.

  13. So glad to hear that things are still going good. Good and stressful but there’s not much you can do about that. so many risks but it sounds like they have a plan for you and baby so that is good. No need to take any crazy risks just try and get everyone delivered healthy and keep mom healthy.
    so crazy September is almost here.
    Things not going just in this beautiful picture you have sucks but you can mourn it but thats just how it is. I still mourn Maya’s babyhood. Even with Benjamin I was suppose to be there for the delivery and i got there too late then they wouln’t even let me see him until the next day. This was hard not only on me since there he is laying by himself in his plastic tray, just born. It was also hard for his birthmom who wanted me to have him and hold him. Oh well, infertility makes everything a bit interesting, and deosn’t ever seem to follow the plan we had in mind.

  14. checking

  15. Sorry about the above- not being very computer literate tonight.
    Any way- very happy to hear that things are still going well and the little one is where they should be 😉 It sounds like you have been learning all that you can about the NICU- as someone else has said at the gestation you are going to he/she may not need a NICU stay. I am keeping my fingers crossed either way NICU or not that you are going to have a beautiful (works for a boy or girl) little one and I can’t wait to hear how much Jaye loves her new little sibling.
    I keep checking in almost everyday and when I see a post like the above I smile- you have an amazing little fighter there and the addition to your family is going to breath-taking! I keep you and your amazing family in my thoughts and prayers! If you have any questions that come up, you know where I am. Get as much rest as you can, soon you will be chasing a toddler and a newborn. Much love to you Luna<3

  16. So good to read your update. I know weighing all these risks is so tough, but I am incredibly impressed by how informed you are about things. If I were in this situation, I would probably have my head stuck in the sand like an ostrich, fingers in ears, going “la-la-la-la” rather than having to make any decisions. What a brave lady you are! But I think I already knew that a long time ago.

    Much love to you and your family these next few weeks…

  17. I am checking in often, thinking of you and sending you good thoughts and prayers for this all to turn out well. So very exciting and terrifying all at the same time. I am focusing on the exciting!

  18. Glad things are going so well. I don’t envy you the position of weighing those risks.

    One other thought I have had – and I am sure it has been on your mind and discussed – why don’t they let parents have a more hands on approach in the nicu?

    I had always decided that if I had a preterm baby (well, it would depend on the how preterm and I am sure other factors) i would fight to hold the baby on my chest 24×7. I always thought I should have a neonatologist on my side for when the baby was born. Just a thought.

    Hard to believe still.

    • thanks for your comment, kami.

      whether parents can be more hands-on in the NICU just depends on how much care and intervention the baby needs. so, for ex., if baby is hooked up to a ventilator or has breathing tubes, it’s pretty tricky. plus there’s lower immunity for lots of preemies, and a concern about germs (and skin contact). in other cases, they let parents in as much as possible. they’ll support nursing if it’s possible, but many babies have feeding tubes and can’t latch yet.

      you can bet I’ll be fighting for as much contact as possible. but right after birth I’ll be undergoing surgery that could take a few hours and they will likely whisk the baby off to ICU. I’ll be lucky to get a few minutes of skin contact at all. then it will be up to Mac to push for more until I’m in recovery. after that, we’ll just have to see how much contact we’re able to have. then push for more…

  19. continued good fighting, you.

  20. I can remember feeling that prematurity was superior to my body failing once again. It’s like, they can help the baby outside, but my body couldn’t be trusted.

    Only at last it was trustworthy. It gave me two great girls after failing so often before.

    I think you can trust it this time, Luna. I know it’s hard though.

  21. Sending you some wishes for peace and calmness in the next few weeks and hoping that things are quiet for just a little longer.

  22. I am new reader and found your site in an adoption search. I am glad things are working out for you. My son was born at 29w6d in SF and at 2 years, 9mos is thriving. Your little preemie will be fine and I believe even stronger for fighting so hard to be here. Most importantly the bond will be stronger than you can imagine. Lots of kangaroo care. Wishing you all the best!

  23. […] there was a chance they’d want to deliver our baby even earlier than expected. Because of the serious risks of dangerous preterm labor and an even more complicated procedure due to complete placenta previa […]

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