Will my baby live?

When I got that news that Mabel had low fluid, I truly understood that the prognosis was bad, but it was hard to really wrap my head around the idea that she might actually die. Part of the difficulty was that no one would actually say she was going to die. Obstetrics would hint, very strongly at it, but couldn’t tell me with certainty. Pediatric specialists wouldn’t comment at all- they all simply said we’d have to see when she came out.

At one point we met with a neonatologist that was finally a bit helpful in that respect. I had been getting weekly ultrasounds for several weeks when we saw him- had had one that day even, which at that point had shown anhydramnios, or no fluid at all. When he heard that, his expression became very serious. He too couldn’t tell us for sure our baby would die, but he was able to get across the point that he was not optimistic for our child. It’s possible he told me nothing new, and after several weeks I was finally able to really hear someone tell me bad news. But I think it was also helpful that he dealt with babies like Mabel. Before him, those giving me the dire prognosis were in OB- they didn’t deal with the baby when she came out, so I didn’t give them as much credit as I should have.

Despite my better understanding of her poor chances, I still remained hopeful. Perhaps it would have been easier if someone could have just told me she would die- her condition was incompatible with life. Then I might have reframed my pregnancy differently.

Later, when I was hospitalized, my midwives came by daily to check in on me. I had many visitors, and everyone tried to remain upbeat. I was pretty positive myself, finally feeling “safe” on continuous monitoring. But I had my moments too- I often just wished I knew what was going to happen (so I could prepare- I thought.)

One day when one of my midwives was visiting, we were having a more serious conversation- about the what ifs. Of all my care team, I talked to her most about the what ifs- what if my baby died? How do I be a midwife? How do I answer when asked if I have kids? She had given me the book “An Exact Replica of a Figment of my Imagination” that just felt so powerful and helpful at the time. For some reason, I could talk to her most easily about the hard stuff. Maybe because others would say- “don’t think like that!” or “no! Miracles happen! Babies surprise us!” or “you don’t know what’s going to happen, why plan for the worst?” But she wouldn’t. I suppose she was the perfect example of empathy. She would stop and really think about what it must be like to be facing such an unknown reality. On one of our visits in the hospital, I asked her “Can I ask you something honestly? Do you think my baby is going to live?”

“No,” she said softly.

And at that time, it was helpful. Partly because I had been asking- not simply being told. Partly because it was her- she wasn’t trying to get me to understand, she was simply imagining it for herself.

I recently saw her for a concern of mine- one that got me super nervous.   Leading up to my appointment I was calm, pushing away bad thoughts- but once I got there, I couldn’t hold back the tears. At the end of the visit, one she basically spent reassuring me, I stopped her and said,

“When I was pregnant with Mabel, I asked you if you thought she would live. You were honest with me. That was really important to me. Today, what do you think- will I be ok??”

“Yes,” she said softly, in that same tone of voice she used with Mabel.

And I believe her.

Do you have someone you trust to tell you the truth? Someone you can hear the truth from? Is there someone you look to for reassurance that everything will be ok?

Sometimes knowledge is power and sometimes knowledge is pain

I have a friend who is a doctor and she shares snippets of her daily life- the trials and tribulations of a resident physician, her patients and the lessons about life she learns. Some stories are beautiful and uplifting. Some make me cry. Some make me cringe. All are insightful.

Recently she wrote of a meeting of providers- discussing their patients’ cases and one of them, an oncologist was distracted because he had recently learned of his mother’s breast cancer. He had trouble focusing on the meeting because he knew better than anyone what the diagnosis meant for his mother and his family.

“Because sometimes knowledge is power and sometimes knowledge is pain.”

This was me, my entire pregnancy with Mabel. I had a week before my first ultrasound where I assumed everything would be okay. Until there was no heartbeat and we thought I had a blighted ovum. Seeing a heartbeat a week later, confirmed a viable pregnancy but I spent the rest of the first trimester knowing what it felt like to miscarry and worried I’d be feeling that way again. Though I told my family I was pregnant before my genetic testing, I asked them not to share the news until we got the results, because even though I had no risk factors, I knew it could still happen to me. When I learned Mabel had Down Syndrome, I decided to accept the diagnosis, but it wasn’t simply recognizing I’d be raising a child with special needs. It was also recognizing that I might not be- I was all too familiar with the risk of miscarriage and stillbirth with the diagnosis (ironically, I wasn’t thinking about neonatal loss). When we were told her kidneys weren’t working, she had no fluid and if she were even to be born alive, her lungs would likely be too small to sustain her life, I had some hope, because what mother doesn’t? But I also knew. I’ve told people myself when there is no fluid at early gestation that their baby will die. I knew.

Yes, sometimes knowledge is power. I was able to research and make my own educated and informed decisions about my body and my baby. But knowledge was also pain for me. I never enjoyed my pregnancy like I should have, like I wished I did; it was too tainted with worry.

I’m sure those of you out there who have had a pregnancy after loss also know that knowledge is pain. There are some of you who may have learned that lesson with your first pregnancy, like me.

Is knowledge power? Is knowledge pain? What is your experience?

Storytelling regret

I told Mabel’s story to a patient who was kind enough to ask- but had been rude to my staff and frankly too cavalier and too familiar with me. I will tell my daughter’s story as often as I can, but I didn’t like how she asked so nonchalantly “so, what happened to your baby?” It wasn’t nerves or awkwardness; I think it was her personality. “So you knew, then?” she asked matter-of-factly when I told her about the low fluid, the non functioning kidneys and potential for small lungs. “No, we didn’t know if she would live or die. No one could tell. We just had to wait and see when she was born.” I was annoyed that she seemed to imply that knowing ahead of time made it easier for me. It minimized all the grieving I did in my pregnancy and all the grieving I did (and am still doing) afterwards. Worst of all was her casualness about it all. I was left with the impression that she thought it could never happen to her. Newsflash- it could. It probably won’t, but it could.  For the first time, I felt some regret about sharing.

Have you ever shared your loved one’s story and regretted it afterwards?

Day 27: Express

36+2

Today I have been without Mabel more days than I had been with her. For 36 weeks an 1 day she was safe. Despite the low fluid, my body nourished her, grew her and comforted her. All her needs were met and she wanted for nothing. She was safe. She didn’t need kidneys or lungs- my placenta did all their work for her. Her clubbed feet fit nice and snugly in my uterus. The holes in her heart made no difference- just added to the flow. Her extra chromosome was invisible inside me. I would have kept her in longer if I could. A few days before labor I asked if we could push out my induction for two more weeks and was thrilled and relieved when my high risk doctor and midwives thought it was a good plan. Mabel thought differently. She decided at 36 weeks that she her time inside me was up. I like to think that had she stayed inside longer, she might have died or had such distress I would need a c-section, and so she chose to come on her own so that I could meet her alive and have the vaginal birth I had hoped her.

last photo of me, pregnant at 36 weeks and 1 day, moments before Mabel and I became two separate beings.

Today is 36 weeks and 2 days since that day. She has been out longer than she has been in. In a few more days she’ll have been buried, in the dark of the earth, longer than she had been snuggled in the dark of my womb.

Her memory fades with time. Sometimes it’s hard to believe that she was real- that this really happened. Holy sh*t, I had a baby. I was a mother. My daughter died. I don’t remember what it felt like to be big and pregnant except for the random phantom kicks I still get. They are sparse and an awkward reminder because my baby had no fluid, so she wasn’t the biggest kicker. My pregnancy almost feels invalidated by her death. No one will ask me about my experiences when they are pregnant for the first time. No one will seek my advice. No one will ask for baby clothes hand me downs. And then they’ll have their babies and I ‘ll be even more useless, because though I had a baby I know nothing of parenting a live child- unless of course someone wants advice about taking their baby off life support.  I know a few things about that.

I thought I would do something to mark the day I turned 36 weeks and 1 day without Mabel, but the day came and went. It feels like my due date felt- an end to something that I don’t want to end.

Today I’m sad that the time I will be without my daughter will continue to grow longer and longer but my time with my daughter will forever be shorter.

#CaptureYourGrief

Dear Bootcamp Instructor

Dear Bootcamp instructor,

I was never a fan of group exercise.  I was happy running when I wanted, for how long I wanted.  But as pregnancy shaped my body and complications with my baby arose, I found I couldn’t run for both physical and emotional reasons.  With a broken elliptical at home and no gym membership, I was uncentered and anxious without my exercise routine.  I finally caved in to a friend’s entreaties to join her at “bootcamp.”  My first class, I arrived early and sat in a near panic attack as all the women in the 6pm class performed different exercises in near seamless coordination.  Everyone looked so good!  I was overwhelmed.  Then the warm up nearly did me in.  I left feeling on the fence about whether this bootcamp was for me.  I tried again at an early morning Wednesday class and left still feeling undecided.  I had an ultrasound later that day with my doctor (a fellow bootcamp-er) and I remember telling her I was like 50/50 on whether I liked it or not.  I gave it one last shot on a Friday morning class that you were teaching.  When I left, I began thinking, I could like this.  In the car on the way to dinner later that night I was telling my husband about my day and told him about the good class I went to with the friendly instructor.  And then there you were at the restaurant- smiling and remembering my name!  Like I told you the other day, that’s what sold me.

Over the next three weeks, the exercise saved my sanity.  I learned to love jam ball slams for the anger I could release about my baby’s health.  When I was admitted to the hospital, the doctors (my colleagues) all had a good laugh at rounds about how their admission for the day (me) would be late because she wanted to go to bootcamp.

I tried to continue the pace in the hospital, taking time each day to do a mini-bootcamp while tethered to the fetal monitor.  You’d be surprised what one can do in a small hospital room attached to a six-foot wire.  My husband even got me a medicine ball for my birthday, which I celebrated in the hospital.  I yearned to do some jam ball slams, but my midwife and doctor (also fellow bootcamp-ers) didn’t think it would be a good experience for the patient in the room below me.  My doctor thought I was a great research project in itself, showing that a baby with no fluid did just fine through vigorous exercise.  How cool it was to watch her heart rate never falter while I did ball taps and squats.  Your class was even on my mind in labor as I told my midwife between contractions, “this is harder than bootcamp!”

My midwife let me return to bootcamp at 2 ½ weeks postpartum, under her supervision.  My daughter was buried, my family had all left and my husband was back at work- I was alone and terrified of my grief.  In the initial days, I wouldn’t get out of bed, barely eating.  Going to bootcamp gave me a reason to get out of bed, brush my hair and eat breakfast.

Upon returning to my first class, I sat in the car crying until the last possible moment.  I was scared of the memories- being somewhere that I only knew in pregnancy, seeing people who might ask about my baby, unaware that she had died in my arms.  I made it in that day, as you know, and many days that followed.  That first day wasn’t the only day that saw tears.  The nice thing about bootcamp is I can’t make it through a class without a red face dripping with sweat- a nice camoflauge for the emotion that would spill out without warning. 

Bootcamp allowed me to step out of myself for a bit.  I took a momentary vacation from my sadness everytime I thought “only ten more seconds of climbers,” and sometimes I dove deeper into my grief, using my anger to push me further.

As you may have noticed, I come pretty much exclusively to your classes.  I found myself going almost exclusively to your classes, looking forward to the bubbliness and kindness you showed.  You didn’t treat me weird- you didn’t ignore the fact that I was back, no longer pregnant but childless, nor did you treat me like I had some sort of leprosy.  I was comfortable.  I was coming to your mid-morning classes (one that I dubbed the “mommy class” because of all the kid chatter that happens before warm up) and I could come alone- without the crutch of my friends from the earlier classes- because I knew you.  You knew my name from day one.

I often think that the person you see at bootcamp is not the “real” me, though I’m not so sure anymore.  There I know I am quiet and keep to myself. Other bootcamp-ers might even find me unfriendly, as I learn how to smile and make small talk again.  I might not show how much I enjoy being there and how much my body and mind need to be there.  This new timidity and shyness is a function of the “after.”  In my other life, the one “before” I carried a baby I knew might die, “before” I had to take my daughter off life support, “before” my world came to a halt, I was outgoing and friendly and would have told you all this in person.  I suppose that is why I am writing this.  All the times I have referred to “bootcamp” in writing this, I‘ve really been thinking of YOUR bootcamp.  I feel like I’m in AA, going back, making amends, thanking all those who have helped me on my journey.  I was procrastinating writing this because my journey is far from over, but a friend encouraged me to do it.

So in case I haven’t been vary clear… Thank you.  Thank you for your cheer, your motivation, for knowing my name, learning my story and welcoming me.  Thank you for giving me a temporary reprieve from and insight into my sorrow at the same time.  Thank you for making your class a warm place, full of exertion and encouragement.  You’ve helped me enormously.  You are an excellent trainer and wonderful person.

Thank you.

 

How’s your son?

“How’s your son?” I asked her over the phone, after I answered her questions.

“He’s good!”

“He was diagnosed with Down Syndrome, right?”  I remember seeing her postpartum, standing by the warmer in the NICU.  She had declined prenatal testing because it wouldn’t have changed how she felt about the pregnancy.  When her baby was born, the pediatricians thought he had several characteristics of a baby with Down Syndrome, so he was in the NICU for evaluation.  She was a bit unbelieving at first, not ready to fully accept the diagnosis until the test results were in.  I knew they’d both be fine.  She came from a lovely extended family that took care of each other.  That baby was lucky, I had thought.  No one rejoices at the diagnosis of Down Syndrome, but I knew that baby was going to be loved on so much.

“Yeah…”

“Did you know, I had a baby with Down Syndrome?  She didn’t make it though.”  I was able to say the words easily.

“Oh no! I’m so sorry!  You were able to make it to term?”

“Yeah- thirty-six weeks.  She was born in February.”

“Oh no, what happened?”

I explained that we knew she had Down Syndrome since 13 weeks but continued on.  I told her about the kidney problems and the low fluid making her lungs underdeveloped.  Ultimately she died because her lungs were too small.  She told me how sorry she was and that she’d pray for me.  She marveled at how she felt like she’s hearing about so many more people having babies with Down Syndrome. I told her I thought a lot about her and her son throughout my pregnancy.  The emotions I had in the beginning- grieving the diagnosis at first- and then the preparations I did.  I told her how amazed I was that she did all that while having a brand new baby.

“How is your son?” I asked, knowing that 50% of children with Down Syndrome have heart defects and many have other birth defects and later health problems.

“He’s good! He’s got nothing major- just low muscle tone. He’s teaching himself to crawl,” she described her one year-old’s slightly delayed progress.

I asked who her pediatrician was. “Is he in Birth to Three?” referring to the early childhood support program in our state.

“Yup!  They have therapists that go to the day care and to the home.”

I told her about the Down Syndrome Comprehensive Clinic, and she took the information eagerly.  I told her I was glad her son was doing so well.  She thanked me and said she’d be keeping me in her prayers.

I felt good about it all.  We shared something special.  I wish I could have been the woman on the other end of the phone- the one whose baby lived- but I nonetheless felt good.

No One Tells Us Babies Die

On the plane I was reading a Real Simple magazine.  In the issue they had a writing contest- tell us about a time when you were brave.  The winner was a woman who wrote about taking her 3 day old son off the ventilator.  Her baby was significantly premature and suffered from a severe brain hemorrhage, so his prognosis was dire.  She and her husband did not want their son to suffer so made the choice to withdraw life support and make him comfortable as he died.  I read that article and my chest got tight- with both sadness and a small amount of excitement.  Excitement might not be the right word, but I was overcome with the urge to shout “me too!”  To let this woman know I’ve been there too.  I wanted to hold up the article to the person in the seat next to me and say this article is about me!

No one tells us babies die.  I, of all people, should really understand that they do.  I’ve seen it.  But deep down inside, I thought modern medicine would win, especially if my baby was not stillborn.  I can oddly comprehend the incomprehensible- that sometimes babies died in the womb for no reason at all.  Unpredictable and unavoidable.  But once they’re come out, shouldn’t we be able to save them?  I’ve seen babies born on the cusp of viability, with their weight measured in ounces rather than pounds, grow and live.  How could my baby, who made it to near term and was a hearty weight for 36 weeks, not respond to all that modern medicine had to offer?

I had an ultrasound at 22 weeks that showed normal fluid.  My next one at 27 weeks showed low fluid.  So we knew that sometime in between those times the fluid became low.  If the fluid was low 22-24 weeks, my baby had essentially no chance.  If it became low later, there was some chance.  Once Mabel was here, there was no way to say when that fluid was low, but I can make my guesses.  She died because her lungs were just too small.  They weren’t developed enough.  Babies have a chance of survival after 24 weeks because their lungs have passed the most basic of milestones and could potentially respond to ventilation.  I think my baby had lungs of a 22 week baby.  While I was pregnant I think I really just assumed the fluid became low after 24 weeks.  I knew that still meant she could die, but I thought she at least had a chance.  I don’t think she did.

Am I glad to have not known?  At 33 weeks I wrote “The unknown can sometimes be better than a known sadness.”  I think that’s true.  The unknown leaves room for hope.  The decisions we had to make were hard, but also more welcome than some others.  We chose to hope for life.   If Mabel was given a fatal prognosis, I might have been able to deliver early, bury my baby and move forward.  It was even something I talked about with my high risk doctor.  But we thought Mabel had a chance, and I’m glad.  Making that choice might have left me with a lingering wonder- what if I went to term, would it have changed anything?  Because there was uncertainty, there was hope, be it small, and the choice was then easy.  We made that choice at 13 weeks, when we learned Mabel had Down Syndrome- we hoped for life.

No one tells us babies die.  They do.

Mabel’s purpose?

A friend was trying very hard to make sense of this all.  There has to be something good that can come out of this, right?  Why was Mabel sent here?  Everyone has a purpose, so what was her purpose?

Is there a lesson to be learned?  I sure hope not.  The lessons I can think of are: don’t be anxious about the little things.  Don’t take anything for granted.  Look how strong you are.  Why did I need to learn those lessons?  I know plenty of anxious people or people who don’t know their own strength- why do I need this education and they don’t?  It brings me back to what did I do to deserve this?  I rather not try to make sense of it- it’s just statistics.  Has to happen to someone at some point.  A numbers game.

A better way to help people process my situation is to look at what positive things have come from it.  I’ve already talked of new relationships, a better sense of compassion and the privilege of having the experience of pregnancy.  But I suppose this blog is another benefit.  When Mabel was diagnosed with Down Syndrome, I was eager to hear peoples’ stories of prenatal diagnosis.  I wanted to find someone like me.  Most peoples stories involved diagnosis at birth, because few people continue a pregnancy diagnosed with Down Syndrome.  Here is one story that can help with the lack of published experiences.  I worry that it may turn some people off- when you are given a diagnosis of Down Syndrome and you opt to accept the pregnancy, you want to hear how it turns out well.  This is not that story.  But I hope others can related to worries I had before the oligohydramnios and that part of my story can help them process.  Maybe it’ll help some people opt to continue a pregnancy with Down Syndrome.  That would be nice.

When I started this blog I thought it was merely interesting, or unique, to work in obstetrics and have a pregnancy complicated by Down Syndrome.  Little did I know how unique my situation would become.  To this day I have yet to find another person who had my set of diagnoses: baby with Down Syndrome, kidney failure, oligohydramnios and potential pulmonary hypoplasia.  But statistically there will be someone else out there at some point who shares these diagnoses.  I can help her.  My story is most similar to those with kidney agenesis (absence of fetal kidneys).  That is usually diagnosed 18-20 weeks, so their journey is different.  Some choose to terminate. Some choose to continue and then have a longer journey of uncertainty than I did.  But the feelings and the outcomes are the same.  So I join and contribute to that community.

And then there are those of you who read Mabel’s story and think a little differently about pregnancy, family and life in general.  I’m not sure how it helps, maybe you could tell me.  How has reading Mabel’s story made an impact on you?  What more good can come?

I’m not ready

I’m not ready.

 

I have been working so very hard about not thinking too far ahead into the future.  I still try not to think too much about the “whatifs” regarding after the baby is born.  Working so hard, that I am neglecting some preparations.

 

I had my last outpatient ultrasound today.  We were going to measure growth- which made me nervous.  Growth, or lack thereof, is one thing that could derail our plan.  If baby’s not growing, time to deliver. Induction starts and a long inpatient stay is avoided.  I want ready for delivery.  I don’t think baby is ready, and I am certainly not ready mentally.

 

When they measure growth, the sonographer takes measurements of the baby’s head circumference, abdominal circumference and certain leg and arm bones.  As she does them, a little figure pops up on the bottom of the screen. The figure says how many weeks the head or bone or belly is measuring.  I’m 33 weeks and 5 days.  The measurements I could see were seeming to be closer to 29-31 weeks.  Normally I wouldn’t think much of it because clinically I know that third trimester ultrasound can be off by 3 weeks or so.  But I was watching two weeks ago as they took the same measurements and the numbers didn’t seem to change much.  As we waited for the doctor I told Chris “I don’t think the baby grew.”  But after all the calculations, the baby had growth 300gm in the two weeks (we needed a minimum of 200gm to feel good about growth- and keep me pregnant.)  Four pounds even was what my little karate carrot weighed in at today.  27%.  Good movement. No fluid. Small bladder. Barely visible kidneys (though that’s also a function of the low fluid-harder to see organs in general).  I get to stay pregnant!  I got a dose of rescue steroid to help with the baby’s lungs in the event of delivery in the next two weeks (a shot in the butt! the first butt shot I’ve had as an adult, or as far back as I can remember). I return tomorrow for the final steroid dose.  Friday I have my last prenatal appointment with my midwife. I am making some concrete moves to prepare.  Though in those minutes between sonographer and doctor, as I waited to see if I’d have to deliver now or not, I realized just how unready I am for the birth of my baby.

 

I go to the hospital in 3 days and I have done no preparation.

 

I feel like I have little documentation of this pregnancy. I know of three photos of me where I am visibly pregnant.  I did not envision doing the weekly “here’s my baby bump” series, but I did think I’d want photos of me pregnant to show my children when they got old enough.  And even now, I feel like it would be proof- proof that the whole thing happened.  In case I have no baby to bring home, I want to be able one day to point at a photo and “see, look, I was pregnant once.”  Now I have three days to make that history.  Maybe some hospital pictures would be in order.

 

Packing.  I made a hospital bag a few weeks ago- a small one with just the necessities, that I bring with me to appointments- in case they send me right over to the hospital, like they did at 27 weeks.   But I haven’t packed a long-term bag.  I haven’t even made a list (and I am a list maker).

 

And I think I ‘m in denial that I’ll actually have to labor.  It’s not that I’m planning on a c-section (though I certainly know it’s an option if there is significant distress); it’s more that I haven’t gotten to the stage that I honestly believe the baby will come out of me.  We did a childbirth education class (yes, even midwives do childbirth prep- so no excuses for patients who don’t think they need it!).  I have started a playlist for labor songs.  I have a tennis ball for back pain and heating packs for everywhere else pain.  But labor still seems so theoretical to me.

 

I was at the chiropractor today and she knows all the basics of my situation- she’s all business when she asks about it, but in a good way.  She asked if I’m ready to go into the hospital.  She also asked if I was ready at home.  I told her no, not at all.  I haven’t been planning to take a baby home.  If this baby joins us in the world living and breathing, s/he will be having a nice long stay in the hospital.  I figure we can do the shopping then.  If it looks like the baby is working towards discharge, then we can buy a crib.  Then we can build a baby wardrobe of especially girly or boy-y clothes.  Then we can share the baby registry Chris and I had been working on before the oligohydramnios.  Then we buy whatever medical supplies our baby needs.  I realize I might need a few things in the interim, but that’s what family and friends (and amazon prime) are for.   Breastmilk storage bags and bottles for the nourishment I can save for my baby when s/he can eat.  Nursing bra. Baby outfits for photos.  A little baby hat.  A lovey.

 

I need to buy a baby outfit.  Something classic, simple, natural.  We will consider it a coming home outfit.  Though really, I feel like I need it in case we bury the baby.  Another form on coming home.  If that’s the case, I want the outfit to be something special- something I’ve picked out with love.  And I can’t imagine that I’ll want to be shopping for an outfit if I’m actually planning a funeral.  So this I want to do ahead of time, but I just can’t seem to bring myself to do it yet.  I’ll put it on the to-do list.

 

I need to make a to-do list.  Something to refer to when I hit boredom in the hospital.  Or if I’m feeling particularly anxious, something I look at to find something to distract me.

 

As I begin my preparations to go into the hospital, I am constantly struggling with both relief and fear.  I am excited, in some ways, to give up the burden of anxiety and let others watch my baby like a hawk.  But I am terrified of what’s going to happen.  There is still a lot of unknown.  If I only knew, for sure, I would be there for three solid weeks, I could work hard on adjusting to the “after” birth during that time.  Maybe begin to realize that I will labor.  But I could go in on Saturday and be delivered that day, depending what the baby shows on the monitor.  I could end up with a very quick c-section, skipping a long labor that might in many ways be therapeutic to experience.  I’m terrified of the emotions I’m going to feel, the further uncertainty I will face with a sick child.  Will I bring the baby home?  Will I be caring for my baby full time?  Have I just had my last days as a midwife?

 

For now, I am going to plan on a nice extended stay.  My baby has been a mover and gets a good BPP (Biophysical Profile- an ultrasound test for fetal well being- looks at certain baby movements and fluid) score- 6 out of 8, the best a baby can get with no fluid, so I’ll consider that an A.  My baby has been getting straight A’s, like his/her mamma, since 27 weeks. This makes me believe my baby will behave on the monitor.  I plan on laboring and pushing out my baby.  I am tall, confident in my ability to push out a big baby, so a small one should be a piece of cake, right? My midwives will be patient with my baby to allow me every chance at a vaginal birth if it’s safe for us.  I am planning on a live baby.  I think I’ll meet our little carrot and hear a cry.  Maybe even have a tiny moment of skin to skin as the cut the cord?  I plan a team of pediatrician helping my baby breath and see what s/he can do on his/her own.  Beyond that, I have no plans.

I got mad at the baby

I got mad at the baby yesterday.

 

Chris and I spent the weekend in Vermont.  Our friend has a family ski condo where we stayed.  The weekend was centered around “Romp to Stomp,” a snowshoe race/walk that benefits breast cancer.  Originally I was going to be on call this weekend, so Chris was to go up with our couple friends and I’d miss it.  But since work has been kind enough to keep me off call, I can use the time in ways that help prepare for our road ahead.  It was a nice quiet weekend away.  The three of them did the race- waddling off quite quickly in a small pack of racers.   I did the walk, the same 3k trail, but starting 30 minutes after them at a slower pace, surrounded by other participants in pink tutus and bandanas as a salute to the tatas. I had no pink, but I do think I was by far the most pregnant woman walking.

 

The walk felt similar to running- it was definitely a good work out.  I was huffin’ it pretty good. Lots of up hill and then down hill.  From the get-go I could feel my pubic bone getting angry.  There’s a joint in that bone that gets loose for some people in pregnancy- a response to the body’s hormones and the pressure of a growing baby.  But that looseness can cause pain, especially with certain activities- its called symphaseal pubic dysfunction.  It was pretty uncomfortable but I powered on- all the while telling myself:  “Labor is uncomfortable too. This is practice.”   I enjoyed it, but afterwards I suffered a bit all day.

 

When we came home, we all were pretty spent.  We pretty much conked out and napped for a few hours.  When I woke up I lay there waiting for baby to move.  I had been too preoccupied to really notice movement all day, so I wanted to take some quality time to check in.  After twenty minutes or so of not feeling anything, despite some poking and prodding, I got out of bed and ate some chocolate and started drinking water.  An hour passed by and I still wasn’t sure I was feeling movement.  I started freaking out.  Had I been home, I think I would have called my midwives.  I told Chris how nervous I was and he tried to reassure me. He’s so calm.  But when I get worked up, it can be hard to talk me down.  I knew if I waited until like 8 or 10pm, I might feel more, because that’s when the baby is most active.   But all I could think about was that I wasn’t ready to lose the baby.  We had a plan.  I need more time. I want to meet the baby.

 

And then the baby moved.

 

The relief was huge.  The closer we get to our hospital admission, the more burden I feel to make sure the baby is moving.  The more worried I get that we wont make it to the admission.

 

And then I got mad at the baby.

 

I had wanted the baby to move so bad.  I needed the baby to move.  But the baby wouldn’t until s/he was ready.  Apparently this is an early parenting lesson.  We have no control over our children.  Once baby was done with a nap, s/he got going.

 

It happened again today.  I just get so scared so easily.  Baby is allowed to sleep, but I wish I could just communicate with him/her and say “Move! Just a little so I know you’re there!”  I need to know the baby is ok.

 

Five more days until I check into the hospital and the burden is no longer mine.  I’ll let the nurses and the monitors let me know baby is fine.  It’ll be reassuring for me that other people are ensuring that my body is doing what it can to nuture this baby.  I know i’ll be trading this worry for another, but the closer I get the more wiling I am to trade.  Five more days.

 

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I wanted to take a minute and say thank you to the many people who email/call/text/comment/facebook.  And those who just read.  I have been terrible at responding, but please know that I read each of your comments and notes and appreciate them so so much.

 

 

And lastly, an old friend was diagnosed with lung cancer within the past year.  I’ve known him since college and he was in med school while I was in nursing school at the same university.  His was the first familiar (and friendly) face I saw when I arrive my first day.  He was recently published in the New York Times regarding his scary diagnosis in the setting of little data about lung cancer in someone young like himself.  And he’s in medicine- knowing so much (too much?) about it all.  I have ridden my rollercoaster regarding my baby’s diagnosis.  I can not imagine riding that rollercoaster regarding myself.  An excellent read.

 

http://www.nytimes.com/2014/01/25/opinion/sunday/how-long-have-i-got-left.html?_r=0