She's Here!

Clara Elizabeth was born June 14th. Birth story and all will now be on my family blog.

Picture comparisons

I had planned on doing this earlier so the weeks would be the same, but hey. I wanted to compare my baby bellies. The first picture is me at 34 weeks with Tyler and the second is me at 37 weeks with Clara. I know it's 3 weeks difference, but its still comforting that my 37 weeks picture is bigger than my 34 weeks picture since size has been such an issue this pregnancy. That's got to mean growth right?

Tyler

Clara

Finally!

So they never called, but I had an appointment yesterday and finally got the results of my ultrasound - AFTER I asked about it. He was all ready to send me out the door and I meekly asked, "ummm what about my ultrasound???" Oh yes, that thing I sent you in for to scare the pants off you. Well, he doesn't seem too worried anymore which is a good thing, but according to the numbers she still isn't really growing much. As of this last ultrasound she is in the 22nd percentile which is 12 percent lower than the first one. I know he told me 45th percentile initially, but apparently he meant 34th because that's what he told me yesterday. But he asserts that every ultrasound at this stage has a 10 percent standard deviation on both sides so she is probably fine. He didn't tell me anything about her measurements so I'm guessing if he's not too worried that they at least increased a little. He said he is not worried about a chromosomal defect, because if it were to show up, it would have showed up earlier, or IUGR as they have to be below the 10th percentile for that to be an issue. Phew! a sigh of relief there. He said most likely its nothing or a genetic defect - being a problem with her metabolism (aka liver, kidney, intestines, etc). But those are fairly rare so most likely its nothing, she's just small. Really small apparently. But I hold to me my belief that these ultrasounds are notoriously off. I've heard so many stories of babies being in these low low percentiles and then coming out quite average or vice versa, being in high percentiles and coming out smaller. He said that since her movement is good, which it is thank goodness, and I have no risk factors things are probably fine.

However, he went ahead and sent me in for an NST yesterday to check heart rate and amniotic fluid level. Good news is that she has plenty of fluid surrounding her and the nurse/technician lady giving me the NST said that usually if there is a problem with the baby or the placenta the amniotic fluid would be low so YAY! Another good sign! Her heart rate was a bit high, but she didn't seem overly concerned - just reminded me to drink more water. Her movement, like I said earlier, was also good, so good news all around. Pretty much at this stage we just wait for her to come. There is no way to know if there is a metabolic problem until she's born and obviously her size is pretty much a guessing game until she's here - so wait and see it is.

I am feeling a bit worried, but mostly confident that everything is fine. All signs point to a healthy (albeit small) baby. Good amniotic fluid level, good movement, healthy mommy, some growth (I think), and I remember at my last ultrasound the technician pointing out her bladder and tummy being full, which in my mind means she's at least giving that metabolic system a workout, and all her organs looked good at her level II ultrasound months ago and I don't see why that would have all of a sudden changed. All in all, unless there is a problem that has gone undetected, which does happen occasionally, she is fine. I'll be 37 weeks (full term!) tomorrow and as much as I want her here already, I want to give her as long as possible to grow grow grow so hopefully I'll go my last 3 weeks.

Don't Worry. . .

I feel better now. I had my night of freaking out and now I'm good. I still don't know the results, but that's ok. Two things happened. First, it seems like every time I feel I have a worthy cause to throw a pity party over, I find out about someone who has it so so so much worse and I kind of wake up and realize whoa what are you crying about? I had that happen to me yesterday twice and I felt terribly ashamed of myself. Ashamed of the stink I was making about something that wasn't even an issue for sure. Something that most likely would end up being fine. Ashamed that it took someone else's pain to show me what I had/have to be grateful for. So, I kind of snapped out of it and looked at my life and had a bit of a change of heart.

Second, I had an epiphany yesterday evening as I was driving home from work. I had been worrying about what ifs all morning and then at some point in the day I became too busy to think about what ifs and I forgot and stopped worrying. Then, when I got in my car and had gone maybe a mile a little thought came: "Hey, remember your baby might have something wrong with it." It was the strangest thing because it really came as a little voice like that. And then without fail another little voice said, "You don't HAVE to think or worry about this. Why choose to worry about something you have no control over?" It was almost like having a devil and an angel on my shoulders like in cartoons. Now, its not like I didn't know worrying was a choice or that I'd never thought of that before, but for some reason it was different this time. It really became a choice this time. I don't know really how to explain it. And hopefully the next time I have something to worry about (because believe me, I will find something else to worry about) I will be able to make the same choice. It was like I finally saw worry for what it was - a thing draining me of vitality and love and joy and I was able to erase it just like that. I really don't know how else to explain it. I don't know if it was just a little tender mercy for me when I needed it most or if I am finally starting to learn how to deal with my worry wart complex or both, but whatever it was I'm glad because since then I have been able to focus on the things that matter, the things I have control over. I am hoping for the best outcome possible for this little girl and I am grateful for experiences that wake us up and remind us what we have to be grateful for and the power we have over our own thoughts and feelings.

Follow up Ultrasound

I had my follow up ultrasound today. I don't know the results yet. Oh how I wish that they would just let me see a doctor so I didn't have to play this waiting game! I was able to see the screen this time (whether the technician knew it or not I'm not sure). At first I thought oh haha now I can figure things out on my own without having to wait! YIPEE!! Then after watching, I realized this was not a good thing. I figured out that on the screen it showed the gestational age for each measurement. I only figured this out towards the end so I only saw the last few measurements. But those last few measurements just fueled my worry. I know they take multiple measurements since there is so much room for error the bigger the baby gets so, like I said, I'm only going off the last few I saw, which probably isn't a good idea in itself. But nonetheless, I looked and I saw and now I'm worried. The measurement I saw for her head was 34 weeks and some days. Not bad. I am supposedly 35 weeks and 3 days so about a week or so behind, which I think is considered pretty normal (but we already knew her head was normal). The measurement I saw for her femur, however, was at 32 weeks and some days. That is quite a bit smaller. And thanks to google - or no thanks to google - a short femur length is a marker for down syndrome. Yay something else to add to my list of worries. I didn't catch a gestational age for her abdomen but I think I remember the cm measurement and from what I remember it put her abdomen at about the same gestational age as her femur - 32ish weeks - small again. Now I'm hoping that if I'm right about that measurement that her abdomen still grew. Since my last ultrasound was at 32 weeks and it was smaller at that time then a measurement of 32 weeks 3 weeks later would indicate some growth right? And yes, I do notice a lot of problems with my logic. First, I'm going off only the few measurements I saw. Second, I have nothing to compare it to since I never got the actual measurements from my last ultrasound so for all I know she could be growing right on target, just on the small side. And third, I could have read or understood these all completely wrong. Oh WHY DID I LOOK? There's a reason they usually turn the screen away from you. I want another level II ultrasound so I can have a real live doctor show me and tell me everything. UGH! Stupid Kaiser. This time when they call I'm asking for a detailed rundown of everything! I don't want to be left in the dark again. I hope they call soon. Oh please oh please call soon!

AHHHHHHHH!

Seriously this is getting ridiculous! Today I had a prenatal appointment and my measurements were "ok" and the heart rate was good. When I asked him about the ultrasound results he told me she measured in the 45th percentile. I'm not sure if that means weight, height or both. Anyway, that is a decent measurement. Then as I was waiting for the nurse to schedule my next appointment he called me back into his office and told me that while her head had measured fine, her abdomen had been small. What in the world!? Then why did the nurse call me and tell me that everything looked good?? She even said that she had a perinatologist look at it. She assured me several times that everything was good. So WHAT IS GOING ON? Again, I didn't have the wherewithal to ask him any of that or how small her abdomen was. All I know is that it's small enough to cause him some concern. And not sure if that's a serious concern or a "just in case" kind of concern like last time. Anyway, he did tell me that this could mean asymmetrical IUGR which is usually a problem with the placenta. Because the brain is a vital organ it gets the majority of the blood so the head grows, but the lesser organs (aka bowel, liver, skin, etc) get placed on the back burner and she doesn't develop as much fat. Another term is "chronically starved." Isn't that a lovely phrase? I'm gaining weight like crazy, but she isn't! Anyway, he ordered another ultrasound to check the growth of the abdomen. The poopy part is that you need at least 3 weeks between ultrasounds to get an accurate rate of growth so it won't be for about another 2 weeks. That is a much longer wait then last time.

The good news is that asymmetrical IUGR is better than symmetrical IUGR. Symmetrical IUGR is usually a problem with the baby and it develops during the beginning of pregnancy, while asymmetrical IUGR is a problem with the mother/placenta and it develops during the third trimester. Basically, her brain and major organs should be ok it's just me starving her and her poor lesser organs aren't developing like they should! Most the time the babies catch up in weight and height within the first year. As far as I read there are little to no developmental delays (since the brain is spared - actually it's called the brain sparing effect) and that most asymmetrical babies have an excellent long term prognosis. Labor and right after delivery for these babies is the scariest part. Because the placenta isn't working well, these babies have a higher chance of all sorts of complications and labor has to be monitored very closely. Apgar scores can be lower, they have a higher chance of spending time in the NICU and all sorts of other things. Sometimes, depending on severity and what not, a c section is the better option. Even then these babies have a harder time right after birth. Still birth and post birth mortality rates are also higher, but not by too much. I think as long as they monitor you closely you're fine. There are obviously chances that the organs that got kind of left out will have problems too, but over time those generally catch up and gain all normal function. Some studies show babies with asymmetrical IUGR have a higher chance of developing hyperactivity, diabetes, hypertension, and obesity, but if that is the case its just a higher chance and we can combat that with good eating habits and exercise. The other good thing is that if this next ultrasound does give her a diagnosis of asymmetrical IUGR I will be 36 weeks and some days so even if they do have to take her I'll be practically full term. Much better than the 32 weeks I was last time. I think induction is the usual course of action depending on the severity of the IUGR since she isn't getting the nutrients she needs from me and can get them better from the NICU. Sometimes I think they prescribe bedrest if it's not too bad. UGH! But being as far along as I will be it wouldn't be for too terribly long. All in all, it isn't the worst diagnosis in the world and for the most part babies with asymmetrical IUGR end up perfectly healthy and normal. I don't have ANY of the risk factors that can contribute to asymmetrical IUGR so hopefully this is nothing. I'm trying not to worry and I'm praying that her abdomen catches up and that this ultrasound shows normal growth and that this was another "just in case" from a very careful doctor. I am grateful that he is so careful and double checks everything. I'd much rather have these extra ultrasounds and deal with a little worry then have a serious problem get overlooked. She may be here sooner than we think - or may not. I'll know in a couple weeks.

The Long Stretch

Could my third trimester possibly go any slower? I'm 34 weeks todayish. Remember when I was 30 weeks? Yeah, me too. And that feels like an eternity ago - not just 4 weeks. Sometimes I feel like I'm never going to have this baby. I'm just going to be pregnant the rest of my life! Come on June. Get here already! The sad part is once June finally does get here I still have almost the entire month to wait. And I really do want to wait. As tired as I am of being pregnant I am not one of those women that reach 37 weeks and starts trying to induce labor. I have a firm belief that the closer to your due date, the better for your baby. There's a reason pregnancy goes 40 weeks. And that reason is not just to drive you crazy, although that is definitely accomplished in the process. At least at 37 weeks I can stop worrying about preterm labor. This girl is so low that sometimes I feel like she might just fall out.

Aside from the pregnancy doldrums I feel really good. My pelvic pain is gone, she moves, and because she is so low I can breathe pretty well. I mean really for 34 weeks I am doing good. I have a lot to be grateful for and then I get all bummed that I have six weeks left and then I get more bummed that I'm not enjoying every minute of pregnancy. Is it ok to not enjoy every minute of pregnancy - especially when your pregnancy is going so well? Shouldn't I be rejoicing and shouting my joy from the rooftops? Can't I be bummed and rejoiceful at the same time? Grateful yet ready? Happy yet bored? Cuz that's what I am. I am both of all those things. Well, I guess I can be all those things, I just need to focus on the more positive aspect of my pregnancy conundrums. So here's to six more weeks of an AWESOME, STUPENDOUS, FANTASTIC, MARVELOUS pregnancy. (and I really do hope it's six more weeks - no more no less).