Linc at our NT scan at 13 weeks.
Saturday, June 14, 2008
Our baby story
I am currently 33 weeks pregnant. Pregnancy and babies are pretty much all I think about these days. Well in truth I have been thinking about it since about this time last year when I found out I was pregnant for the first time.
Here is the backstory...
I ran out of the free birth control pills from college in October of 2006, and Andy and I decided to instead of buying more, to start trying for a family instead. I had always read to avoid getting pregnant the first couple of months after coming off of birth control, so we used other protection until Christmas of 2006. At that point we decided to start trying for a family. We finally got pregnant May of 2007 after some crazy irregular cycles. I got a positive home pregnancy test the day after Memorial Day.
This is where the baby drama begins! I dropped the bomb on Andy that night, and needless to say he was in shock. Which was a bit of a surpise to me because we had been trying to get pregnant for many months already. But I guess it was just the shock of knowing that it was really happening. I took 2 more home pregnancy tests just to make sure it wasn't a fluke test or something. All of them were positive. I jumped on the internet that night and started reading all about pregnancy and what I was supposed to do to be a good mommy and have a healthy pregnancy. Mostly what I got out of it was that I needed to start drinking a lot of water. So that night I drank like a gallon of water, and the same thing the next morning. By then end of this crash rehydrating sessions I was using the restroom every 20 minutes or so. That day I went to the TMC birth center and took a free pregnancy test. It came back negative. I was so confused, but the nurse told me that maybe it was just too early and that I should come back in a week. The next day I went to the UMC women's center and got tested again. It was still negative. This nurse told me that I was not pregnant and that the home pregnancy tests were false positives. Well needless to say I did not believe her and instead took the nurse's advice from TMC and headed back there a week later. At that point my pregnancy was finally confirmed and my estimated due date was set for February 4th 2008!
The next week I was headed home to celebrate my twin little sister's graduation from high school. I suprised them all with the news that I was pregnant. It was very exciting! My dad told me that he was hoping that I would go 2 weeks overdue and have the baby on his birthday, the 18th of February. I was just hoping to avoid having the baby on Valentine's Day...especially if it was a boy. But after thinking about it I thought that that would have been kinda a cool birthday to have as well. Silly me getting so caught up in inconsequential things like that.
Time passed uneventfully and my first prenatal appointment at 10 weeks arrived. All of my bloodwork was taken, and the CNM listened for the heartbeat with the doppler. She couldn't find it, but told me not to worry, I was probably just a little earlier than I thought. She sent me to Obstetrix for a follow-up ultrasound the next week. Based on my last menstrual period I should have been 11 weeks and 3 days. The baby was there moving around a bit, I could see the arms and legs, the umbilical cord, and most importantly the heartbeat. The baby did measure a little bit behind at 11 weeks even, but that was well within the reasonable range.
More time passed and my 14 week appointment arrived. The CNM had to spend a while searching for the heartbeat with the doppler but finally found it. It was reading at 170-180 bpm. This seemed high to me, but she told me it was normal. She told me at the next appointment that it would be much easier to find the heartbeat because the baby would be much larger. This was a relief to me, as apparently I had an uncooperative baby when it came to the doppler.
The next week Andy and I went on vacation in Oregon/Washington to see 2 weddings and roadtrip around the northwest. I was still not showing, so I had to tell everyone why I was not drinking. Basically this was the first most of our friends had heard about it because I wanted to go as long as possible without telling...just in case. I came back from the vacation and made the announcement at work when I was 17 weeks pregnant. They had wanted to send me away for months of field work, and I thought that that would not have been a good thing while pregnant. So the news was out and everyone knew...
My next prenatal appointment with the TMC birth center was the day after Labor Day at 18 weeks 1 day. I was thinking about how I was uncomfortable going the a birth center to deliver my baby and decided to switch to a OB. I had set up my first OB appointment for that Thursday. So I headed to the TMC appointment on Tuesday September 4th, this time Andy came with me. This was his first baby appointment! We got there and had a long chat with some expectant parents in the waiting room, she was due the next day! Talking to them got us really excited and I know that I at least had all kinds of visions of how the next February would turn out. We headed to the back room and again the CNM could not find the heartbeat. She spent many long minutes searching. Then she stopped and felt my uterus. She said that I was measuring small. She asked if I had felt the baby move, I said that I hadn't felt anything that I was sure was the baby. She asked if I had had any cramping or bleeding, I said that I had not. She did an internal check, and said that my cervix was closed and felt good. She brought in another CNM to listen for the heartbeat, and again they could not find it. They obviously looked worried. She told me that it was possible that the baby was lying transverse and that was why I was measuring small, and that my palcenta could be anterior thus blocking the sound of the baby's heartbeat. But I could tell that even she wasn't buying that story. At that point it was after 6pm because they were running hours behind schedule and it was too late to head over to Obstetrix for an ultrasound to see what was going on. We were told to come back at 8am the next day and that they would try to get us in first thing in the morning for an ultrasound to see what was going on. Thus begins the longest night in my life...
I spent most of the night crying on Andy's shoulder. I was almost positive that our baby was dead, but because I didn't know for sure, I spent a long sleepless night having an internal dialogue with myself, back and forth between hope and despair. I currently consider this night the worst one in my life. I hope to never repeat this night for as long as I live.
The next morning we went back to TMC, but the earliest they were able to get us in at Obstetrix was noon. So we waited, and waited, and waited. We spent about an hour waiting in the waiting room of obstetrix. This was particularly sucky because everyone kept coming out of the back with pictures of their little babies, while we were sitting there waiting to find out if ours was dead. Finally we were called back. I told the tech that I was 18 weeks and the CNM at TMC could not find the heartbeat with the doppler. So she took a look, and I could tell right away that the baby had died. There was no heartbeat and no movement. The tech said that the baby looked to have passed around 13 weeks. I told her that this was impossible because we heard the heartbeat at our 14 week appointment. She then said that it had probably already started at that point. The baby's body measured right around 13 weeks, the legs measured 14 weeks, and the head measured almost 15 weeks. I am figuring that the baby passed around 15 weeks, but due to the chromosome problems that we found out about later, that its growth was being restricted.
I was given my options...wait for my body to finally recognized the lost pregnancy and take care of it on its own, or to have a D&C. I opted for the D&C because it had already been weeks since the baby had passed, and my body obviously had no idea what was going on. I had the D&C that Friday, September 7th, 2008.
The next step...healing and trying again.
In the weeks that followed I was luck to find a pregnancy loss forum on the internet where I could share my story of loss, and grieve with the other women there. In all honesty, over the past year, it has become clear to me that no one can understand what it is like to lose a pregnancy until it has happened to them. The inappropriate or insenstive comments, or the lack of understanding, or even knowing what to say. Each person who was told responded differently, and very few of them actually "did it right". But that is okay, most of them had never had this happen to them and just could not understand. Everyone is human, and I expected these types of mistakes, although they still could hurt, and hoestly they did end up seriously effecting of a few of my relationships with friends and family, and not for the better unfortunately.
We were told by our midwife that we could start trying to get pregnant after the follow-up D&C appointment. The GYN who performed the D&C told us to wait 3 months. And the genetic counselor told us to wait 3 cycles. Well from past experience I figured that it would take us another 1/2 year at least to get pregnant again, especially since my hormones were so messed up from being pregnant. So we started trying to get pregnant right away again. About a month after the D&C the chromosome karyotyping came back. It was 46xy-abnormal. This meant that we were pregnant with a baby boy, what we both had hoped for. He had the correct number of chromosomes, but there was some genetic material from one of the 18th choromosomes attached to the other 18th chromosome. The one that was too long probably was not an issue as the body has developed ways to cope with this sort of genetic error. However, the shorter 18th chromosome formed a ring in its attempt to correct itself. This was the problem that eventually overcame our baby boy 4 months after the mistake was made, during the very first cellular division. The genetic counselor who reviewed our case was concerned that one of us may have been the carrier of a rearrangement of the 18th chromosome thus causing this error. This condition is know as "balanced translocation", and what could have been passed down was an "unbalanced translocation". So we freaked out, rushed in that day to give blood samples so we could be tested. And spent most of the night on the internet and with our biology books. After much research we found information that encouraged us. If we were to conceive naturally with this condition, something like 25% of pregnancies would be normal, 50% would carry a balanced translocation (non-fatal), and 25% would carry an unbalanced translocation (fatal). However we learned about IVF with PGD. An expensive but usually successful way to guarantee a pregnancy with a normal fetus. So as we waited the long month for our lab results to come back, we had hope, whatever the outcome.
Fifty days after my D&C I got my first period. I had begun charting and temping so I knew that I had ovulated as well. This was encouraging, as it showed that my body was getting its groove back, so to speak. Early November we got the call from our genetic counselor that our blood tests were completely normal, and that the genetic problem with chromosome 18 was a total fluke. A relief to be sure!
Now that we had the "healthy" green light, I was fairly desperate to become pregnant again, and seriously became obsessed with all things baby. I knew that this was my coping mechanism to deal with the continuing sadness of our lost baby. Andy was getting pretty tired of this obsession, and by the end of the month, honestly, so was I. However, the obsession all started up again in a completely new way when I found out I was pregnant for the second time the Saturday after Thanksgiving, November 24th, 2008!
A new baby!
This current pregnancy has gone loads better than the first one, obviously. But it is in no way an ideal pregnancy. I found out I was pregnant on a Saturday, and that following Monday I scheduled my first OB appointment for December 19th at 7 weeks even. That Wednesday (at 4 weeks pregnant) I had some spotting. I called my brand new OB's office and told the nurse about the spotting. She said that it was probably implantation spotting, and that I was probably just fine. I told her that I had already had implantation spotting 6-8 days after ovulation (because I was charting I knew when this was). I also told her about my previous miscarriage. She decided to get me in for an early ultrasound the following week. At 5 weeks 1 day I had my first ultrasound. Dr. B identified the gestational sac, and confirmed that it was in the uterus. However, when she measured it she said that it was very small...less than 4 weeks. I knew that this was impossible because I knew when I ovulated. I told her this, and she said that she would send me to get some bloodowrk done. These are called "betas" and the blood test measured the HCG (pregnancy hormone) in the blood, and they said that the levels should double every 48 hours. So I ran off to the vampires to get some blood drawn that Thursday, and again that Saturday. I recieved a phone call from the OB's office on Monday around 10am. The levels had come back and hadn't doubled the way that they liked to see. The nurse told me to come in at 11am for an ultrasound, and possibly scheduled a D&C. The fact that the nurse mentioned a D&C seriously freaked me out! I did not want to go through that again!
I found out that the betas came back at 5,438 and 9,000. A doubling time of ~53 hours. I knew that these were not that terrible, but I also knew that if the sac had not grown and was still measured less than 4wks, than this pregnancy was in serious trouble. Well I got right in and the doctor saw that the sac had grown! It was now measuring 4wks 4days, when I was supposed to be 5wks 5days. So still small, but there was obvious growth. Also, in addition to this there was a baby visible, measuring 6wks even. However, this is the threshold where there should have been a heartbeat, and there was no cardiac activity visible. Dr. B gave us a 50% chance of viability. We were told to come back in a week. So now it was back to the waiting game. Back to wondering if I had a baby in there that was alive or dead.
My viability u/s appointment was scheduled for December 19th, I would be 7 weeks along. This turned out to be the same day as my first appointment would have been if the spotting hadn't shown up. This was also 2 days before we left town for X-mas in Oregon, and 1 day before my Dr. B left town for Cambodia. I was trying to figure out what we would do it the pregnancy turned out to not be viable. I really did not want to got to Oregon with a dead baby, meet my 6 month old nephew for the first time, and possibly start a messy miscarriage while away from home. I was pretty sure that this pregnancy was not viable based all of the bad appointments I had had so far.
Well the day arrived. Andy was with me this time. This was going to be his first doctor visit with this baby, and I was really hoping that it would turn out much better than the last time. We went in got all set up, and right away we could see the heartbeat. Andy gave me a high five he was so relieved. I think I just about passed out. I could really not believe it! The baby was still measuring ahead at 7wks 2days, and she didn't even bother measuring the sac again. She said that sometimes measurments that early are not very good, but around 7-8 weeks the baby better be measuring spot on. This was the best possible news, my due date was set for August 4th, and we could go home and break the news to our families...we were expecting again!!
The weeks passed uneventfully. I ordered a home doppler around 9wks, because there was no way that I was going to be carrying a dead baby around for weeks again, thinking that everything was fine. In the weeks to follow this turned out the be the best investment ever, but I didn't know this yet. The doppler arrived in the mail when I was 10wks 1day, so of course I tried it out right away. It took about 5 minutes, but I finally found the baby. Its heartrate was 172bpm. I found the baby everyday after that, just to make sure. I woke up to some more spotting at 10wks 4days, which scared me quite a bit, but I knew that the baby was alive because I had been listening to its heartbeat every night.
My next prenatal appointment was at 11wks. I told her about the spotting and she said that it was probably my cervix being too sensitive, and that I should avoid sex for a week. She found the h/b with the doppler, after a long search, but I wasn't worried because I had already found it right before heading off to the appointment. Everything was fine.
Three days later I woke up to a puddle of blood. I stood up and it was running down my legs and dripping on the floor. I sat on the toilet and so much blood came running out of me that it sounded like I was peeing. I wasn't. This was mre blood than I had ever seen before, even during my heaviest periods. I was really really scared. I called the OBs office and told them that I was 11 weeks along and that I was gushing blood. I got in for an emergency ultrasound that morning. Everything looked fine with the baby, and to our relief, the placenta looked fine as well. She said that my placenta was at the top of my uterus and that I would not have to worry about placenta previa at all during this pregnancy. She again said that it was probably from a vessel in my cervix, and that things looked normal from what she could see. Well this was great news, but little did I know this was the beginning of a long 2 months.
The bleeding continued off and on going from some days of nothing, to days of full on bleeding with clots, followed by days of spotting. Lucky for my sanity we had the home doppler, which I began to use 2 times a day, once in the morning and once in the evening, just to make sure.
At 13 weeks even we had our NT scan. This is a early ultrasound and blood test for down's syndrome, and trisomies 13 and 18. During our visit with the genetic counselor that previous Novemeber we had learned that if we had had this done with our first pregnancy, we would have know that there was something wrong with our baby earlier on. So the time leading up to this NT scan I was very nervous for the results, and the constant bleeding that was plaguing me did not help. At the scan the tech asked me if I had had any bleeding. Andy and I both laughed and said yes, quite a bit. The tech said that she could see a pocket of blood just above my cervix, and said that it was not harming the baby and could have even possibly been a vanishing twin. I didn't really believe that that scenario was possible because we had already had so many ultrasounds (4) and had never seen another baby or sac even. Regardless, all the baby's measurements looked great at the scan, and a week later the bloodwork came back at 1 in 10,000 chance for both the Down's and trisomies 13 and 18. Thank god! So that is one more hurdle to have crossed, and life would have been very good if it weren't for the pesky bleeding.
My next prenatal appointment was at 15 weeks, and after almost a week of no bleeding, I woke up to a bunch more fresh blood. I spent the drive to work ont he phone with Andy crying, so he decided to come to my appt with me. Because I was so upset Dr. B did an emergency u/s at my check-up (Andy was late, so he didn't get there in time). Again, she could not see where the blood was coming from and blamed my cervix. She looked the baby over and asked if I wanted to know the gender. This suprised me because they could not see anything at 13 weeks, and I thought that it was still too early to tell. But I said sure, and she told me that it was a boy and then attempted to show me his penis. I couldn't see it, but I figured that she knew what she was doing. She told me not to run out and buy a bunch of blue stuff yet, but she was still pretty sure. When I got out to the waiting room, Andy was sitting there so I told him the baby looked healthy still, and the Dr was guessing that it was a boy. You should have seen him perk up and strut his way around the place. :)
The bleeding continued until 16wks 4days where it abruptly, but not unthankfully stopped, and never came back (at least not in that same manner). After a week and a half of no bleeding I took myself off of "pelvic rest". That was nice. During this interval I also went back to the vampires to get my 2nd trimester bloodwork done. This one was to check for nurual tube defects like spina bifida. Thankfully, this test also came back normal.
Our "big ultrasound" was scheduled for March 12th, at 19wks and 2days. At this ultrasound they look the baby over carefully, heart, spine, kidneys, stomach, diaphragm, arms, legs, brain, and face to see anything that could possibly be wrong. Most genetic problems can be idenfied at this point. As you can understand, I was pretty nervous for this day and baiscally still in denial about this being a successful pregnancy because I had only just then passed the point where my first pregnancy was lost, and I knew that this ultrasound was the make or break point. I had only just begun to feel the baby move, and I was pretty scared because I wasn't showing at all. I was afraid that Dr. B would find out that my uterus was measuring behind again and that the ultrasound would show significant growth problems with our baby. I had even gone so far as to not buy any maternity clothes yet, and force myself into my one pair of jeans that fit day after day. It turned out that all that worrying was for naught and that the baby looked great! He was confirmed to be a he, and was measuring 19wks 4days, and his head was measuring over 20wks! This worried me a bit, but she said that it was probably just the angle of the picture that was taken. His estimated weight was between 10-12 ounces, so just perfect for his age! This day was a huge relief for me, so much so that I finally took myself off to buy some maternity clothes for the first time ever.
More pregnancy drama...
So at this point I was feeling pretty good. I was halfway through my pregnancy, the bleeding had stopped, and all signs pointed to a healthy baby. My next prenatal appointment was at 23 weeks. The night before this appointment Andy and I were with our friends and we were playing some games in the park. That evening I has some bloody mucus, and freaked out again. I told Dr. B the next day, and I told her about my maternal history of incompetant cervix, which we had previously always blamed on my mother's exposure to DES in utero. She decided that I could get my cervical length checked to make me feel better. It measured long at 3.9cm, which was very good. At 11wks during my first emergency ultrasound due to the bleeding she had measured my cervix and it was 4.5cm, so very long. She said that these measurements were normal and that some shortening was to be expected as the baby got heavier. She said that I should ask the be measured again at my next appointment. My blood pressure at this appointment was 148/68, a weird reading, but high none the less. My doctor didn't say anything about it, so I didn't start to worry until a few days later after reading about pre-e and hypertension on the internet. Which was dumb because I worried myself for nothing.
At 26 wks 1day I came down with the flu. A 24 hr bug that completely cleaned me out, and dehydrated me. On the second night I woke to severe abdominal cramping, so I hopped in the bath hoping to alieviate the pain. I laid there for almost an hour trying to get comfortable, but I could not no matter how I positioned myself. I was scared, it was the middle of the night, and I was not sure what actual labor felt like, but I knew that I had never been in that much physical pain before, I could not even stand up straight. I didn't know what to do, but I did know that if I was having problems with the baby that I would always regret not doing anything. So I called the on-call OB and she told me I was probably just dehydrated, but to head into L&D to get checked out anyway. I woke Andy up and we headed to the ER at 4am May 1st. After getting all hooked up to the machines it turned out that I was just dehydrated and that the baby was fine and my uterus was not contracting. Thank goodness! While we were there I was given 2 bags of IV fluids and the cramping eased somewhat. I spent that day at home and when I woke up I felt almost normal again.
I had my next routine pre-natal appointment the following week at 27 weeks. Because I had just been to the hospital the previous week, and had an internal where the RN said that my cervix was closed and firm, I was not going to ask for an ultrasound to measure my cervix again, assuming that all was fine. Well she had written it down in the chart so I didn't have to ask at all. She came in with the machine, and I stripped down, and she took a look at my cervix, and it was measuring at 2.0-2.2cm with significant funneling! Plus when she applied pressure the length reduced to 1.5cm. This was a very bad thing, and something neither of us really expected at all. I was given an afternoon appointment that day at St. Joe's hospital for a follow-up ultrasound with the prenatal assessment center (the same place we went for the NT scan). On the way home, I called Andy at work and left a message that basically said "I had an ultrasound today, and we have a problem." Figuring that he would call me back for more details, well instead he rushed home in time to go to the appointment, and I have to say he looked pretty scared when he walked in the door. I told him what was going on, and he said oh that isn't that bad. I asked what he expected, and he said something about a 2 headed baby or something that horrible. I told him that the baby is fine, and it was just my cervix causing problems again.
So we headed to the appointment, and the tech said that she did see a shortened cervix measuring around 2.0cm, but she didn't see any funneling. She did recommend that we get the steroid series shots to help mature the baby's lungs if he were to come that week. Although she was recommending this only as a precaution, and she thought that I could make it to 34 weeks if I "took it easy". When I asked what this meant she said not to hike the Sabino Canyon, and to not have any sex. Well neither of these were problems as I had not hiked since 7wks, and we had not had sex since 19wks. Which probably turned out to be a good thing, although I thought we were just being over-cautious at the time. So instead, I put myself on modified bedrest, and did not do anything that I didn't have to do, and spent a boring weekend on the couch.
So we got the steroid shots that Wednesday and Thursday, 24 hours apart exactly. Also, the following Monday I went back to the vampires to take my blood glucose test to check for gestational diabetes. I was pretty worried about this test because I love sugar, and because my father is borderline diabetic so it could be in my genes.
At this point I was having weekly appointments to monitor my cervix, so I was very nervous for what the next appointment would show. At 27wks 2days I went back in, and Andy was with me, we saw that my cervix was still measuring around 2.3cm, but there was no funneling, and no change with pressure. Also, I requested her to look at the size of the baby, and make sure that he was still measuring on time (old fears die hard). Well he looked good. His combined gestation age put him right on time at 28wks 2days, his head was now measuring 28wks, his abdominal circum. was 27wks 6days, and his legs were 29wks. He weight was estimated to be 2lbs 12oz, which was perfectly on time. I was a little bit dissapointed that he was not a super-star in the growth department, as that would have made his possible premature arrival that much better. But on time measurements are much much better than measuring behind. He was also still sitting breech, and had been for at least a month, based on where I was being kicked... I had a fetal fibronectin swab taken, which fairly accurately can predict whether or not a baby will be coming in the next 2 weeks. Later that day I got the call back that it was negative, so it looked like we were safe for 2 weeks! Plus, my glucose test was negative as well! So it was a good day!
The next appointment at 29 weeks showed that my cervix had actually lengthened to 2.7cm with no funneling. So all was good. My BP and everything else has continued to be good as well. I was moved back to every-other week appointments because Dr. B claimed my cervix to be "stable".
At my 31 week appointment my cervix still measured 2.75cm, but did show some funneling. Although Dr. B did not seem too worried about this, because adding pressure did not shorten my cervix any further.
My final cervical check at 32wks 3days showed no funneling, but my cervix had again shortened slightly yo 2.5cm. Dr. B was not worried, and said to come back in 2 weeks. Due to scheduling difficulties my next appointment is July 2nd, almost 3 weeks later. Oh well. I will be 35 weeks by then and probably ready to start up with the weekly dr checkups again.
Here is the backstory...
I ran out of the free birth control pills from college in October of 2006, and Andy and I decided to instead of buying more, to start trying for a family instead. I had always read to avoid getting pregnant the first couple of months after coming off of birth control, so we used other protection until Christmas of 2006. At that point we decided to start trying for a family. We finally got pregnant May of 2007 after some crazy irregular cycles. I got a positive home pregnancy test the day after Memorial Day.
This is where the baby drama begins! I dropped the bomb on Andy that night, and needless to say he was in shock. Which was a bit of a surpise to me because we had been trying to get pregnant for many months already. But I guess it was just the shock of knowing that it was really happening. I took 2 more home pregnancy tests just to make sure it wasn't a fluke test or something. All of them were positive. I jumped on the internet that night and started reading all about pregnancy and what I was supposed to do to be a good mommy and have a healthy pregnancy. Mostly what I got out of it was that I needed to start drinking a lot of water. So that night I drank like a gallon of water, and the same thing the next morning. By then end of this crash rehydrating sessions I was using the restroom every 20 minutes or so. That day I went to the TMC birth center and took a free pregnancy test. It came back negative. I was so confused, but the nurse told me that maybe it was just too early and that I should come back in a week. The next day I went to the UMC women's center and got tested again. It was still negative. This nurse told me that I was not pregnant and that the home pregnancy tests were false positives. Well needless to say I did not believe her and instead took the nurse's advice from TMC and headed back there a week later. At that point my pregnancy was finally confirmed and my estimated due date was set for February 4th 2008!
The next week I was headed home to celebrate my twin little sister's graduation from high school. I suprised them all with the news that I was pregnant. It was very exciting! My dad told me that he was hoping that I would go 2 weeks overdue and have the baby on his birthday, the 18th of February. I was just hoping to avoid having the baby on Valentine's Day...especially if it was a boy. But after thinking about it I thought that that would have been kinda a cool birthday to have as well. Silly me getting so caught up in inconsequential things like that.
Time passed uneventfully and my first prenatal appointment at 10 weeks arrived. All of my bloodwork was taken, and the CNM listened for the heartbeat with the doppler. She couldn't find it, but told me not to worry, I was probably just a little earlier than I thought. She sent me to Obstetrix for a follow-up ultrasound the next week. Based on my last menstrual period I should have been 11 weeks and 3 days. The baby was there moving around a bit, I could see the arms and legs, the umbilical cord, and most importantly the heartbeat. The baby did measure a little bit behind at 11 weeks even, but that was well within the reasonable range.
More time passed and my 14 week appointment arrived. The CNM had to spend a while searching for the heartbeat with the doppler but finally found it. It was reading at 170-180 bpm. This seemed high to me, but she told me it was normal. She told me at the next appointment that it would be much easier to find the heartbeat because the baby would be much larger. This was a relief to me, as apparently I had an uncooperative baby when it came to the doppler.
The next week Andy and I went on vacation in Oregon/Washington to see 2 weddings and roadtrip around the northwest. I was still not showing, so I had to tell everyone why I was not drinking. Basically this was the first most of our friends had heard about it because I wanted to go as long as possible without telling...just in case. I came back from the vacation and made the announcement at work when I was 17 weeks pregnant. They had wanted to send me away for months of field work, and I thought that that would not have been a good thing while pregnant. So the news was out and everyone knew...
My next prenatal appointment with the TMC birth center was the day after Labor Day at 18 weeks 1 day. I was thinking about how I was uncomfortable going the a birth center to deliver my baby and decided to switch to a OB. I had set up my first OB appointment for that Thursday. So I headed to the TMC appointment on Tuesday September 4th, this time Andy came with me. This was his first baby appointment! We got there and had a long chat with some expectant parents in the waiting room, she was due the next day! Talking to them got us really excited and I know that I at least had all kinds of visions of how the next February would turn out. We headed to the back room and again the CNM could not find the heartbeat. She spent many long minutes searching. Then she stopped and felt my uterus. She said that I was measuring small. She asked if I had felt the baby move, I said that I hadn't felt anything that I was sure was the baby. She asked if I had had any cramping or bleeding, I said that I had not. She did an internal check, and said that my cervix was closed and felt good. She brought in another CNM to listen for the heartbeat, and again they could not find it. They obviously looked worried. She told me that it was possible that the baby was lying transverse and that was why I was measuring small, and that my palcenta could be anterior thus blocking the sound of the baby's heartbeat. But I could tell that even she wasn't buying that story. At that point it was after 6pm because they were running hours behind schedule and it was too late to head over to Obstetrix for an ultrasound to see what was going on. We were told to come back at 8am the next day and that they would try to get us in first thing in the morning for an ultrasound to see what was going on. Thus begins the longest night in my life...
I spent most of the night crying on Andy's shoulder. I was almost positive that our baby was dead, but because I didn't know for sure, I spent a long sleepless night having an internal dialogue with myself, back and forth between hope and despair. I currently consider this night the worst one in my life. I hope to never repeat this night for as long as I live.
The next morning we went back to TMC, but the earliest they were able to get us in at Obstetrix was noon. So we waited, and waited, and waited. We spent about an hour waiting in the waiting room of obstetrix. This was particularly sucky because everyone kept coming out of the back with pictures of their little babies, while we were sitting there waiting to find out if ours was dead. Finally we were called back. I told the tech that I was 18 weeks and the CNM at TMC could not find the heartbeat with the doppler. So she took a look, and I could tell right away that the baby had died. There was no heartbeat and no movement. The tech said that the baby looked to have passed around 13 weeks. I told her that this was impossible because we heard the heartbeat at our 14 week appointment. She then said that it had probably already started at that point. The baby's body measured right around 13 weeks, the legs measured 14 weeks, and the head measured almost 15 weeks. I am figuring that the baby passed around 15 weeks, but due to the chromosome problems that we found out about later, that its growth was being restricted.
I was given my options...wait for my body to finally recognized the lost pregnancy and take care of it on its own, or to have a D&C. I opted for the D&C because it had already been weeks since the baby had passed, and my body obviously had no idea what was going on. I had the D&C that Friday, September 7th, 2008.
The next step...healing and trying again.
In the weeks that followed I was luck to find a pregnancy loss forum on the internet where I could share my story of loss, and grieve with the other women there. In all honesty, over the past year, it has become clear to me that no one can understand what it is like to lose a pregnancy until it has happened to them. The inappropriate or insenstive comments, or the lack of understanding, or even knowing what to say. Each person who was told responded differently, and very few of them actually "did it right". But that is okay, most of them had never had this happen to them and just could not understand. Everyone is human, and I expected these types of mistakes, although they still could hurt, and hoestly they did end up seriously effecting of a few of my relationships with friends and family, and not for the better unfortunately.
We were told by our midwife that we could start trying to get pregnant after the follow-up D&C appointment. The GYN who performed the D&C told us to wait 3 months. And the genetic counselor told us to wait 3 cycles. Well from past experience I figured that it would take us another 1/2 year at least to get pregnant again, especially since my hormones were so messed up from being pregnant. So we started trying to get pregnant right away again. About a month after the D&C the chromosome karyotyping came back. It was 46xy-abnormal. This meant that we were pregnant with a baby boy, what we both had hoped for. He had the correct number of chromosomes, but there was some genetic material from one of the 18th choromosomes attached to the other 18th chromosome. The one that was too long probably was not an issue as the body has developed ways to cope with this sort of genetic error. However, the shorter 18th chromosome formed a ring in its attempt to correct itself. This was the problem that eventually overcame our baby boy 4 months after the mistake was made, during the very first cellular division. The genetic counselor who reviewed our case was concerned that one of us may have been the carrier of a rearrangement of the 18th chromosome thus causing this error. This condition is know as "balanced translocation", and what could have been passed down was an "unbalanced translocation". So we freaked out, rushed in that day to give blood samples so we could be tested. And spent most of the night on the internet and with our biology books. After much research we found information that encouraged us. If we were to conceive naturally with this condition, something like 25% of pregnancies would be normal, 50% would carry a balanced translocation (non-fatal), and 25% would carry an unbalanced translocation (fatal). However we learned about IVF with PGD. An expensive but usually successful way to guarantee a pregnancy with a normal fetus. So as we waited the long month for our lab results to come back, we had hope, whatever the outcome.
Fifty days after my D&C I got my first period. I had begun charting and temping so I knew that I had ovulated as well. This was encouraging, as it showed that my body was getting its groove back, so to speak. Early November we got the call from our genetic counselor that our blood tests were completely normal, and that the genetic problem with chromosome 18 was a total fluke. A relief to be sure!
Now that we had the "healthy" green light, I was fairly desperate to become pregnant again, and seriously became obsessed with all things baby. I knew that this was my coping mechanism to deal with the continuing sadness of our lost baby. Andy was getting pretty tired of this obsession, and by the end of the month, honestly, so was I. However, the obsession all started up again in a completely new way when I found out I was pregnant for the second time the Saturday after Thanksgiving, November 24th, 2008!
A new baby!
This current pregnancy has gone loads better than the first one, obviously. But it is in no way an ideal pregnancy. I found out I was pregnant on a Saturday, and that following Monday I scheduled my first OB appointment for December 19th at 7 weeks even. That Wednesday (at 4 weeks pregnant) I had some spotting. I called my brand new OB's office and told the nurse about the spotting. She said that it was probably implantation spotting, and that I was probably just fine. I told her that I had already had implantation spotting 6-8 days after ovulation (because I was charting I knew when this was). I also told her about my previous miscarriage. She decided to get me in for an early ultrasound the following week. At 5 weeks 1 day I had my first ultrasound. Dr. B identified the gestational sac, and confirmed that it was in the uterus. However, when she measured it she said that it was very small...less than 4 weeks. I knew that this was impossible because I knew when I ovulated. I told her this, and she said that she would send me to get some bloodowrk done. These are called "betas" and the blood test measured the HCG (pregnancy hormone) in the blood, and they said that the levels should double every 48 hours. So I ran off to the vampires to get some blood drawn that Thursday, and again that Saturday. I recieved a phone call from the OB's office on Monday around 10am. The levels had come back and hadn't doubled the way that they liked to see. The nurse told me to come in at 11am for an ultrasound, and possibly scheduled a D&C. The fact that the nurse mentioned a D&C seriously freaked me out! I did not want to go through that again!
I found out that the betas came back at 5,438 and 9,000. A doubling time of ~53 hours. I knew that these were not that terrible, but I also knew that if the sac had not grown and was still measured less than 4wks, than this pregnancy was in serious trouble. Well I got right in and the doctor saw that the sac had grown! It was now measuring 4wks 4days, when I was supposed to be 5wks 5days. So still small, but there was obvious growth. Also, in addition to this there was a baby visible, measuring 6wks even. However, this is the threshold where there should have been a heartbeat, and there was no cardiac activity visible. Dr. B gave us a 50% chance of viability. We were told to come back in a week. So now it was back to the waiting game. Back to wondering if I had a baby in there that was alive or dead.
My viability u/s appointment was scheduled for December 19th, I would be 7 weeks along. This turned out to be the same day as my first appointment would have been if the spotting hadn't shown up. This was also 2 days before we left town for X-mas in Oregon, and 1 day before my Dr. B left town for Cambodia. I was trying to figure out what we would do it the pregnancy turned out to not be viable. I really did not want to got to Oregon with a dead baby, meet my 6 month old nephew for the first time, and possibly start a messy miscarriage while away from home. I was pretty sure that this pregnancy was not viable based all of the bad appointments I had had so far.
Well the day arrived. Andy was with me this time. This was going to be his first doctor visit with this baby, and I was really hoping that it would turn out much better than the last time. We went in got all set up, and right away we could see the heartbeat. Andy gave me a high five he was so relieved. I think I just about passed out. I could really not believe it! The baby was still measuring ahead at 7wks 2days, and she didn't even bother measuring the sac again. She said that sometimes measurments that early are not very good, but around 7-8 weeks the baby better be measuring spot on. This was the best possible news, my due date was set for August 4th, and we could go home and break the news to our families...we were expecting again!!
The weeks passed uneventfully. I ordered a home doppler around 9wks, because there was no way that I was going to be carrying a dead baby around for weeks again, thinking that everything was fine. In the weeks to follow this turned out the be the best investment ever, but I didn't know this yet. The doppler arrived in the mail when I was 10wks 1day, so of course I tried it out right away. It took about 5 minutes, but I finally found the baby. Its heartrate was 172bpm. I found the baby everyday after that, just to make sure. I woke up to some more spotting at 10wks 4days, which scared me quite a bit, but I knew that the baby was alive because I had been listening to its heartbeat every night.
My next prenatal appointment was at 11wks. I told her about the spotting and she said that it was probably my cervix being too sensitive, and that I should avoid sex for a week. She found the h/b with the doppler, after a long search, but I wasn't worried because I had already found it right before heading off to the appointment. Everything was fine.
Three days later I woke up to a puddle of blood. I stood up and it was running down my legs and dripping on the floor. I sat on the toilet and so much blood came running out of me that it sounded like I was peeing. I wasn't. This was mre blood than I had ever seen before, even during my heaviest periods. I was really really scared. I called the OBs office and told them that I was 11 weeks along and that I was gushing blood. I got in for an emergency ultrasound that morning. Everything looked fine with the baby, and to our relief, the placenta looked fine as well. She said that my placenta was at the top of my uterus and that I would not have to worry about placenta previa at all during this pregnancy. She again said that it was probably from a vessel in my cervix, and that things looked normal from what she could see. Well this was great news, but little did I know this was the beginning of a long 2 months.
The bleeding continued off and on going from some days of nothing, to days of full on bleeding with clots, followed by days of spotting. Lucky for my sanity we had the home doppler, which I began to use 2 times a day, once in the morning and once in the evening, just to make sure.
At 13 weeks even we had our NT scan. This is a early ultrasound and blood test for down's syndrome, and trisomies 13 and 18. During our visit with the genetic counselor that previous Novemeber we had learned that if we had had this done with our first pregnancy, we would have know that there was something wrong with our baby earlier on. So the time leading up to this NT scan I was very nervous for the results, and the constant bleeding that was plaguing me did not help. At the scan the tech asked me if I had had any bleeding. Andy and I both laughed and said yes, quite a bit. The tech said that she could see a pocket of blood just above my cervix, and said that it was not harming the baby and could have even possibly been a vanishing twin. I didn't really believe that that scenario was possible because we had already had so many ultrasounds (4) and had never seen another baby or sac even. Regardless, all the baby's measurements looked great at the scan, and a week later the bloodwork came back at 1 in 10,000 chance for both the Down's and trisomies 13 and 18. Thank god! So that is one more hurdle to have crossed, and life would have been very good if it weren't for the pesky bleeding.
My next prenatal appointment was at 15 weeks, and after almost a week of no bleeding, I woke up to a bunch more fresh blood. I spent the drive to work ont he phone with Andy crying, so he decided to come to my appt with me. Because I was so upset Dr. B did an emergency u/s at my check-up (Andy was late, so he didn't get there in time). Again, she could not see where the blood was coming from and blamed my cervix. She looked the baby over and asked if I wanted to know the gender. This suprised me because they could not see anything at 13 weeks, and I thought that it was still too early to tell. But I said sure, and she told me that it was a boy and then attempted to show me his penis. I couldn't see it, but I figured that she knew what she was doing. She told me not to run out and buy a bunch of blue stuff yet, but she was still pretty sure. When I got out to the waiting room, Andy was sitting there so I told him the baby looked healthy still, and the Dr was guessing that it was a boy. You should have seen him perk up and strut his way around the place. :)
The bleeding continued until 16wks 4days where it abruptly, but not unthankfully stopped, and never came back (at least not in that same manner). After a week and a half of no bleeding I took myself off of "pelvic rest". That was nice. During this interval I also went back to the vampires to get my 2nd trimester bloodwork done. This one was to check for nurual tube defects like spina bifida. Thankfully, this test also came back normal.
Our "big ultrasound" was scheduled for March 12th, at 19wks and 2days. At this ultrasound they look the baby over carefully, heart, spine, kidneys, stomach, diaphragm, arms, legs, brain, and face to see anything that could possibly be wrong. Most genetic problems can be idenfied at this point. As you can understand, I was pretty nervous for this day and baiscally still in denial about this being a successful pregnancy because I had only just then passed the point where my first pregnancy was lost, and I knew that this ultrasound was the make or break point. I had only just begun to feel the baby move, and I was pretty scared because I wasn't showing at all. I was afraid that Dr. B would find out that my uterus was measuring behind again and that the ultrasound would show significant growth problems with our baby. I had even gone so far as to not buy any maternity clothes yet, and force myself into my one pair of jeans that fit day after day. It turned out that all that worrying was for naught and that the baby looked great! He was confirmed to be a he, and was measuring 19wks 4days, and his head was measuring over 20wks! This worried me a bit, but she said that it was probably just the angle of the picture that was taken. His estimated weight was between 10-12 ounces, so just perfect for his age! This day was a huge relief for me, so much so that I finally took myself off to buy some maternity clothes for the first time ever.
More pregnancy drama...
So at this point I was feeling pretty good. I was halfway through my pregnancy, the bleeding had stopped, and all signs pointed to a healthy baby. My next prenatal appointment was at 23 weeks. The night before this appointment Andy and I were with our friends and we were playing some games in the park. That evening I has some bloody mucus, and freaked out again. I told Dr. B the next day, and I told her about my maternal history of incompetant cervix, which we had previously always blamed on my mother's exposure to DES in utero. She decided that I could get my cervical length checked to make me feel better. It measured long at 3.9cm, which was very good. At 11wks during my first emergency ultrasound due to the bleeding she had measured my cervix and it was 4.5cm, so very long. She said that these measurements were normal and that some shortening was to be expected as the baby got heavier. She said that I should ask the be measured again at my next appointment. My blood pressure at this appointment was 148/68, a weird reading, but high none the less. My doctor didn't say anything about it, so I didn't start to worry until a few days later after reading about pre-e and hypertension on the internet. Which was dumb because I worried myself for nothing.
At 26 wks 1day I came down with the flu. A 24 hr bug that completely cleaned me out, and dehydrated me. On the second night I woke to severe abdominal cramping, so I hopped in the bath hoping to alieviate the pain. I laid there for almost an hour trying to get comfortable, but I could not no matter how I positioned myself. I was scared, it was the middle of the night, and I was not sure what actual labor felt like, but I knew that I had never been in that much physical pain before, I could not even stand up straight. I didn't know what to do, but I did know that if I was having problems with the baby that I would always regret not doing anything. So I called the on-call OB and she told me I was probably just dehydrated, but to head into L&D to get checked out anyway. I woke Andy up and we headed to the ER at 4am May 1st. After getting all hooked up to the machines it turned out that I was just dehydrated and that the baby was fine and my uterus was not contracting. Thank goodness! While we were there I was given 2 bags of IV fluids and the cramping eased somewhat. I spent that day at home and when I woke up I felt almost normal again.
I had my next routine pre-natal appointment the following week at 27 weeks. Because I had just been to the hospital the previous week, and had an internal where the RN said that my cervix was closed and firm, I was not going to ask for an ultrasound to measure my cervix again, assuming that all was fine. Well she had written it down in the chart so I didn't have to ask at all. She came in with the machine, and I stripped down, and she took a look at my cervix, and it was measuring at 2.0-2.2cm with significant funneling! Plus when she applied pressure the length reduced to 1.5cm. This was a very bad thing, and something neither of us really expected at all. I was given an afternoon appointment that day at St. Joe's hospital for a follow-up ultrasound with the prenatal assessment center (the same place we went for the NT scan). On the way home, I called Andy at work and left a message that basically said "I had an ultrasound today, and we have a problem." Figuring that he would call me back for more details, well instead he rushed home in time to go to the appointment, and I have to say he looked pretty scared when he walked in the door. I told him what was going on, and he said oh that isn't that bad. I asked what he expected, and he said something about a 2 headed baby or something that horrible. I told him that the baby is fine, and it was just my cervix causing problems again.
So we headed to the appointment, and the tech said that she did see a shortened cervix measuring around 2.0cm, but she didn't see any funneling. She did recommend that we get the steroid series shots to help mature the baby's lungs if he were to come that week. Although she was recommending this only as a precaution, and she thought that I could make it to 34 weeks if I "took it easy". When I asked what this meant she said not to hike the Sabino Canyon, and to not have any sex. Well neither of these were problems as I had not hiked since 7wks, and we had not had sex since 19wks. Which probably turned out to be a good thing, although I thought we were just being over-cautious at the time. So instead, I put myself on modified bedrest, and did not do anything that I didn't have to do, and spent a boring weekend on the couch.
So we got the steroid shots that Wednesday and Thursday, 24 hours apart exactly. Also, the following Monday I went back to the vampires to take my blood glucose test to check for gestational diabetes. I was pretty worried about this test because I love sugar, and because my father is borderline diabetic so it could be in my genes.
At this point I was having weekly appointments to monitor my cervix, so I was very nervous for what the next appointment would show. At 27wks 2days I went back in, and Andy was with me, we saw that my cervix was still measuring around 2.3cm, but there was no funneling, and no change with pressure. Also, I requested her to look at the size of the baby, and make sure that he was still measuring on time (old fears die hard). Well he looked good. His combined gestation age put him right on time at 28wks 2days, his head was now measuring 28wks, his abdominal circum. was 27wks 6days, and his legs were 29wks. He weight was estimated to be 2lbs 12oz, which was perfectly on time. I was a little bit dissapointed that he was not a super-star in the growth department, as that would have made his possible premature arrival that much better. But on time measurements are much much better than measuring behind. He was also still sitting breech, and had been for at least a month, based on where I was being kicked... I had a fetal fibronectin swab taken, which fairly accurately can predict whether or not a baby will be coming in the next 2 weeks. Later that day I got the call back that it was negative, so it looked like we were safe for 2 weeks! Plus, my glucose test was negative as well! So it was a good day!
The next appointment at 29 weeks showed that my cervix had actually lengthened to 2.7cm with no funneling. So all was good. My BP and everything else has continued to be good as well. I was moved back to every-other week appointments because Dr. B claimed my cervix to be "stable".
At my 31 week appointment my cervix still measured 2.75cm, but did show some funneling. Although Dr. B did not seem too worried about this, because adding pressure did not shorten my cervix any further.
My final cervical check at 32wks 3days showed no funneling, but my cervix had again shortened slightly yo 2.5cm. Dr. B was not worried, and said to come back in 2 weeks. Due to scheduling difficulties my next appointment is July 2nd, almost 3 weeks later. Oh well. I will be 35 weeks by then and probably ready to start up with the weekly dr checkups again.
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