Tuesday, July 21, 2009

*ANOTHER 35 Week Update*

After spending the afternoon doing some online research, getting feedback from other mothers on the wonderful ivillage forum and talking things over with Ryan, I have made a decision. I have decided against having the test done Thursday morning for fetal lung maturity. My reasoning is as follows.

1. Almost every site agrees that fetal lung maturity is usually reached by week 35, which I am at. Add in that Owen is a larger than average baby and has had the steroid shots to help develop his lungs, and it’s pretty guaranteed that his lungs are mature. From my understanding, the reason Dr’s have to perform this test is to protect themselves from being sued due to performing an elective c-section at such an early gestational age, which I completely understand.

2. The Doctor said repeatedly that if I were to go into labor that they would go ahead and deliver me. I wouldn’t have to reach hard active labor, since they’ll intervene with a c-section anyway, so whenever I get to the point of early labor (regular contractions 5-10 minutes apart), then they would go ahead and take me in.

3. Based on 1 and 2, I have decided to let myself off bed rest. I of course won’t attempt anything too strenuous like long walks or lifting Carter (it has been over 2 months since I’ve had any type of exercise!), but I will start doing stuff around the house again, like cooking and cleaning. If his lungs are mature and it’s ok if I go into labor, then I figure we can still schedule the c-section for 39 weeks as originally planned and if nature takes its course sooner, then so be it, but I don’t want to force him out.

4. The test is an amniocentesis, which does come with risks. The risks are low, but still risks. They include infection, hemorrhaging, leaking amniotic fluid, and preterm labor. The risks alone aren’t deterring me from having the procedure, but just one more thing against it. Also, I could live without the pain of having a needle shoved through my stomach and uterus, which apparently isn’t the most comfortable feeling in the world.

5. Finally, the test is expensive, and based on the above reasoning, an unnecessary expense. The cost of an amnio ranges from $1200-2000. Even after insurance we’d be paying a few hundred dollars out of pocket.

So we won’t be eliminating the guess work of when he’ll come by scheduling a much earlier c-section, but I’ll feel better about letting him “cook” a little longer if that’s how it’s meant to be. As for my suffering through the pain of cramping and contractions, I’ve already found it easier to cope with just by being up doing stuff and distracting myself. It’s much harder to re-direct your attention when you’re stuck in bed doing nothing.

35 Week Check-Up

Well I made it though 4 days of regular contractions, only to wake up this morning to cramping. No Contractions! Still in a lot of pain though after having my muscles worked out all weekend. I went in for my 35 week check-up this morning and found that I am still 2cm dilated, which is good, but also frustrating after suffering so much pain. I am also still measuring large, but we already know that it’s because he’s a big boy.

The Dr. decided that since I’m having so much trouble with cramping and contractions, that she’d refer me to the high risk Dr’s to have an amniocentesis done to check fetal lung maturity. I will have that done Thursday morning. If his lungs are mature then we can go ahead and schedule the c-section for any time. If they’re close to mature, then I may be able to deliver about a week later. However if they’re completely immature, then they’ll try to get me all the way to 39 weeks. She did say repeatedly though that if I go into labor, they will not try to stop it, which is great news to me. Statistically, white males’ lungs develop slower than girls (and boys of different races). She did say that since I had steroid injections for his lung development that they may be further developed. Also, he is a big boy, so he has that working in his favor.

She did say that I will most likely have to have a c-section. Unless I was to go in to the hospital fully dilated and crowning, they’d probably still do a c-section. (Clearly she’s not a big believer in VBAC’s.) Personally, if I were to deliver early, I would love to give a VBAC a shot, since he’d most likely be smaller than Carter’s 9lbs+, but it doesn’t sound like I’ll get the chance. On the plus side, she did say she’d let me have a mirror in the OR to see the birth. She’s never done it before, so she’s not sure how the angle will work, but she’s willing to give it a shot. I’d heard of other women doing this so they could still see their baby being delivered. My one big disappointment with Carter’s delivery was not being able to see him born, so I’m glad she’s going to let my try to see. (From what I’ve read online, many Dr’s refuse this kind of a request).

Lastly, she told me to stop taking the Terbutaline, because it obviously wasn’t working for me. She prescribed me Procardia XL to take instead. It’s primarily a blood pressure medication, but is also used for Preterm contractions. We did ask about how that would affect me, since I have naturally low blood pressure and get really sick when it drops. Her answer was that if it makes me sick then I probably shouldn’t take it. With that in mind, I’m thinking I won’t be filling the prescription, because I already know that even a slight decrease in my BP makes my dizzy and nauseas, and I REALLY don’t want to go through that again.

So I’m a little disappointed that I haven’t progressed more over the weekend, but relieved that they will let me deliver now and not try to stop labor if it does begin (another reason I see to not take the medication). She didn’t say so directly, but Ryan and I both got the impression that I didn’t have to stick to such strict bed rest any longer. (Again, because it’s ok for me to deliver now.) So I am hugely relieved to be able to get up for a few little things. Maybe without the meds and being up a little more, I may go into labor this week after all! I can only hope. I’m definitely ready to get this whole pregnancy thing over with and meet my little boy. :)

Friday, July 17, 2009

34 Week Update

So it’s been an interesting week. As mentioned in the last blog, the midwife gave me medication to take when I’m having contractions. Last Thursday night I started having really bad cramping, so I had Ryan take the prescription to be filled. Since it’s not a commonly used drug, the pharmacy didn’t have it in stock. If they couldn’t locate any in the area I would have had to wait for a shipment to come in on Monday. Fortunately they were able to partially fill the order Friday morning, since by then I was having regular contractions every 20 minutes. One pill and 30 minutes later the contractions stopped. That wonderful episode was after spending 2 days lying down and not sitting up, so I no longer have to do anything to provoke the contractions.

The weekend and the beginning of this week were uneventful, just the normal cramping, which has become par for the course. So I decided to schedule a professional photo session to get some maternity pictures taken. I knew there was a good chance that it would bring on contractions, but I really wanted to get the pictures done and I figured the medicine would help. I did have to stand a little, but mostly I was sitting (car, wheelchair, and poses). I was having a little more cramping then normal last night, but nothing too bad.

This morning though I was having contractions every 10 minutes. I went ahead and took one of my pills and waited for them to let up. An hour later there was no change so I went ahead and took a second pill. Another half hour later the contractions finally let up to just every 15 minutes, but never went away. This afternoon Ryan convinced me to call the midwife’s office for advice since the weekend was coming up. The midwife was concerned that the contractions had been only 10 minutes apart, even after taking the first pill. She instructed me to take 2 pills every 6hrs for the next 24hrs and then 1 pill every 6hrs after that if they haven’t stopped yet. She also said if they get stronger or closer than 15 minutes apart while on the medication to go into the hospital.

So it’s going to be an interesting weekend. The medicine makes me extremely jittery, so it’s hard to do anything. I’m actually only able to type this because the first dose is just wearing off and the next dose of medicine hasn’t fully kicked in yet. Hopefully the contractions will eventually let up. I’m scheduled to go back to the Dr. on Tuesday, at which point I will be 35wks. I hope Owen is able to hang on at least until then. I know he’s big enough to safely come out now, but my first choice hospital for delivery doesn’t take women before 35wks. And whereas I don’t really want another 9lb+ baby, I’d still like him to at least reach 7lbs.

I will post another update after Tuesday’s appointment. That is unless Owen decides to make his debut first. :)

Tuesday, July 7, 2009

33 Week Check-Up

Well I had my 33wk check-up with the midwife this morning. I was anxious to see what she had to say, since I had a rough weekend. I hadn’t really been up doing any walking, actually less than normal probably, but I did do a bit more sitting up. I made it to church Saturday morning with the use of a wheelchair and sat up on the front porch to watch the fireworks that night, plus I ate all 3 meals at the table with the family. By the time I went to bed that night I was in quite a bit of pain. The cramping continued to get worse Sunday, even though the only sitting up I did that day was for meals. By Sunday evening I was having contractions 15-20 minutes apart and woke up several times that night in pain. By Monday morning the contractions had stopped, but I was having constant cramping and all my back and abdominal muscles were in pain from the contractions the night before. The cramping had significantly lessened by this morning, but after being up all morning to go to the Dr’s office the cramping has once again increased, though fortunately no more contractions yet.

After I told her all this she decided she needed to check my cervix again. I have now progressed to 2cm and my cervix is very soft. She said that sitting up probably pushes Owen’s head down onto my cervix, causing the contractions to have an effect. She said the bed rest does seem to be helping though, because if I had actually been up and active I would quite likely have progressed much further already. However, since simply sitting up is now causing contractions, I am to lie down/recline as much as possible. And to help combat the contractions she gave me a prescription for Terbutaline.

The other discovery made at this appointment is that I am once again measuring 3wks ahead, so she ordered another ultrasound to check my fluid levels again. The technician said the levels look good, but Owen is a larger than average baby, though not overly huge. She took several different measurements, but the ones that I remember were that his head measures at 35wks and his body at 36wks (again, I’m only 33wks). She told me at the end that he currently weighs in at about 5lbs 6oz. (Average for a fetus at this stage is 4.5lbs). We also confirmed that he is indeed a boy, as he gave us a nice clear shot between his legs.

I am of course a little disappointed in losing the privilege to sit up, but am reassured that Owen would be okay if he were to come at anytime now. The midwife said that by 34wks they don’t worry too much about lung development, and that at that point it’s just a matter of letting the baby put on weight, and since the little guy’s already over the 5lb threshold, I feel a lot better.

I did finally ask what the chances would be of being on bed rest again if we decide to have another baby in the future. She said she doesn’t know any specific percentages, but that I would have a slightly increased chance, but that all pregnancies are different. She did note though that this has been a healthy pregnancy and they haven’t actually had to stop premature labor yet, so the prospect of bed rest alone shouldn’t be a deterrent. As usual I go back in 2wks. At that visit I will be seeing the Dr, instead of my midwife, to do a c-section consultation and actually schedule the delivery. Fingers crossed I make it ‘til then without any extra appointments.