Saturday, July 5, 2014

20 Weeks and Beyond

After the excitement of the big gender reveal, things were pretty quiet over the next several weeks. (At least on the pregnancy front. We were crazy busy packing up our house and getting ready for our move on May 1). I had a few appointments that were mostly uneventful. Isabelle was growing right on track and I passed the glucose test. Woo hoo!
Easter morning we got up early so Jax could hunt for his Easter eggs and see all the loot that the Easter bunny had brought him. (Sadly, the Easter bunny was lacking in the effort and creativity departments this year and Jax was unimpressed by both the number of eggs hidden and by the fact that he forgot one of his special requests... Ooops!) Then, I made the side to bring to our gathering with extended family that afternoon. I finally went to take a shower around 11 and noticed that I was spotting. My heart immediately dropped. This was particularly scary because of the possibility of vesa previa, so I immediately called the nurse line. They told me to go to the hospital right away.

John dropped me off at the door and went to park with Jackson. Meanwhile, they hooked me up to a bunch of monitors and did a cervical check. Thankfully, the check showed that I hadn't dilated at all and Isabelle seemed to be doing great on the monitor. However, they noticed that I was having quite a few contractions. As a result, they decided to watch me for a couple of hours to make sure that the contractions slowed down and that they weren't causing any cervical changes. They also ran a fetal fibronectin test which can determine if the "glue" that attaches the amniotic sack to the cervical lining is starting to break down (which means you are at a greater risk for premature labor). Jackson and John had joined me in the room at this point and poor little Jax looked so scared when he saw me (almost as scared as I probably looked when I noticed that they had given him a big brother sticker). It was WAY too early for our little girl to enter the world- I was only 27.5 weeks!

Three hours later I was finally given the okay to join my family's Easter festivities. The contractions had slowed down and I passed the fetal fibronectin test. I was told that I better take it easy, though, and that I should follow up with my doc in a few days. My doctor was definitely concerned and put me on modified bedrest, at least until my next level 2 ultrasound which would either rule out or confirm vasa previa or velamentous insertion.

Over the next few weeks, I did my best to take it easy, but this was extremely difficult to do while spending my days with a very active three year. Plus, we moved during this time. We hired movers and had help from friends and family, but it was impossible for me to just sit and watch everyone else do all the work. The increase in Braxton Hicks contractions I had during this time told me that I was probably doing more than I should have.
I had my ultrasound and perinatologist appointment on May 12. Overall, the appointment went great. All of the really scary complications (vasa previa and velamentous insertion) were ruled out and, despite the marginal cord insertion, Isabelle's growth continued right at the 50%ile. The somewhat concerning news was that my cervix had already started to shorten. The perinatologist told me to continue the modified bedrest and to have my doctor perform another fetal fibronectin test at my appointment in a couple days.

I was feeling pretty good after my appointment on May 14. The nurse didn't think it felt like my cervix had changed too much and she thought that I would pass the fetal fibronectin test no problem. That afternoon, however, I got a call that the fetal fibronectin test came back positive! They said I needed to have a series of corticosteroid shots to help Isabelle's lungs develop in the case that she did come early. They wanted to start them immediately, so I had to pack Jackson up in the car (right during his nap time) to go back to the doctor's office (which is now 45 minutes away). Thankfully, we made it in time and Jax was a trooper! When I went back in they also told me that I needed to get full time help with my son, so that I would be better able to follow my modified bedrest recommendation. John and I now had the difficult task of finding a daycare facility, in a new town, that had an opening, and would be flexible since we had no idea how long it would be needed. Ugh. The stress of the day put my contractions into overdrive. I layed in bed, wide awake, most of the night timing my contractions (and stressing out about putting my little boy in daycare). Things had calmed down by the next morning and I went in to get my second shot that afternoon. That evening, the contractions picked up again (even more so than the day before). I called the nurse line and they told me to go to Abbott right away, since they are attached to Children's Hospital and better able to care for premature babies. We threw a few things in a bag, dropped Jackson off at grammy's house, and headed to the hospital. This took over an hour and a half (and had us second guessing our decision to move out the the country)! I prayed to God that John wouldn't have to deliver Isabelle on the side of the road somewhere!

When we got to the hospital they hooked me up to all of the familiar machines to monitor my contractions and Isabelle's heart rate. Isabelle was doing great, but they were a little concerned with the frequency of my contractions (even though they didn't seem to be causing any cervical changes). They gave me a terbutaline injection in hopes of stopping the contractions. That did the trick, but made me feel incredibly shaky and jittery. They decided that I probably had a UTI, which can irritate the cervix and cause contractions. They prescribed antibiotics and sent me on my way. The next week I saw my doctor again. She said that I did not have a UTI... Good news, but a little troubling since that meant all those contractions were preterm labor. She also said that I was now 20% effaced, so the contractions were starting to cause cervical changes. She said to continue modified bedrest and with my weekly check-ups.
32 Weeks (Melissa Pizzalato Photography)
The next weekly visit, which was actually just 4 days later, brought some pretty scary news- I was 80% effaced! Definitely NOT good at only 32 weeks pregnant. At this point, I was put on more strict bedrest. She explained that gravity was not my friend and that I needed to lay down all day with the exception of meals and an "occasional" shower. This was tough news to hear (especially with a nursery that still needed completing and boxes all over our house). Of course, I was willing to do whatever they said to keep my baby girl snug in my belly. She said that it would be great if I could at least make it to 34 weeks. Jackson wasn't scheduled to start his new daycare until the next week, but my mom and John were able to take time off of work to watch Jackson, while I watched hours of Netflix (thank you House of Cards and Friday Night Lights, for keeping me entertained). I also did lots of online shopping to help settle my nesting urges! Best of all, my much anticipated newborn photography class started during this time. I wasn't able to complete most of the assignments, but since it was online I was able to follow along with all of the reading materials and videos and learn from the critiques of the other student's work. (I can't wait to practice on Isabelle!! Poor girl!)

Thankfully, not much changed over the next few weeks. Bedrest helped quiet down the contractions and I stayed right around 80% effaced and 1 cm dilated. Everyone was thrilled when I hit the 34 week mark, but no one more so than John and I. At 34 weeks, I had another level 2 ultrasound with the perinatologist and she said Isabelle continued to look great. She was still measuring right around the 50%ile, which meant that the marginal umbilical cord issue did not seem to be affecting her growth. However, she decided that I should start getting weekly biophysical profiles, amniotic fluid indexes, and non-stress tests to ensure Isabelle's well being. Marginal umbilical cords tend to cause issues during the 3rd trimester, and this was also right around the time in my pregnancy that Jackson started to have a growth restriction issue. Every Monday morning, I spend 2-3 hours at the hospital going through these tests and then meet with my doctor or nurse for a cervical check and to go over the results. It's comforting to start each week seeing my baby girl and knowing that she's doing well!
35 Weeks
Friday, May 20 brought the next round of excitement. My mom had graciously offered to babysit so that John and I could get out for a little date night. (I had been given the ok to be out of bed a little more at this point, since I was just about 36 weeks). We joked that maybe we should bring the hospital bag "just in case." Well, about 5 minutes after we left the house I started having really consistent contractions. They were coming every 3-5 minutes and lasting about a minute. It was about a 45 minute drive to the restaurant and we debated whether or not to go straight to the hospital. I decided that I wanted to enjoy my (cooked) sushi dinner first, while guzzling water (which I hoped would slow down the contractions). We finished our delicious meal around 7pm and the contractions were still coming consistently. They weren't very painful or anything, but I decided to call the nurse line anyway (especially since we were right in the neighborhood). They said I should probably come in to be monitored, just to be on the safe side. So, our romantic date night ended with over 3 hours spent at the hospital (where I got felt up by 2 people other than my hubby). My contractions started to slow down pretty quickly once we were there, of course, and they hadn't caused any further cervical changes. Again I was sent on my way. On the way out, I vowed to John that I wasn't going back to the hospital until I was SURE I was in full blown labor.
The 36 week mark brought a huge sense of relief. Babies born after this point are usually very healthy and can even go home without a stay in the NICU or special care nursery. By this point we had gotten much more settled into our new home and had just about completed the nursery, which also made me feel much more at ease. At my 37 week appointment, I learned a possible reason why she didn't end up coming earlier. She flipped to a face-up position. I had noticed this on the previous several ultrasounds, but didn't think too much of it since she was head down. It's called a occiput posterior position and it can cause babies to go PAST their due dates (go figure!), as well as stop and start labor, longer labor, back labor, and all sorts of other fun things (again I made the mistake of googling this condition and totally freaked myself out). Oh well, it's all worth it if that's what prevented her from being premature. My doctor said it's highly unlikely that she will change positions before I go into labor since her head is engaged and at a -2 station, BUT it's very possible that she will turn (or that they will be able to turn her) once labor starts.

Today, it is July 5 and I am 37 weeks, 4 days, which is exactly how far along I was when I gave birth to Jackson. I never thought that she would stay put longer than her big brother. After all the drama that has conspired throughout this pregnancy, I am so incredibly thankful that she is still safe inside of me (even though she didn't get to wear the darling little 4th of July outfit I had all ready for her). As of the last ultrasound, she is almost 6 pounds! We are all so excited to meet the newest addition to our family, but (as I keep reminding Jackson) she'll decide when she's ready to meet us!

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