Thursday, April 12, 2012

20 Weeks...

Is knowledge power? Or is ignorance bliss?

For sure, it must be a bit of both, but I can tell you that I have certainly longed for a bit more ignorance with this pregnancy!

Last go around I felt invincible. It was all I knew. Women all around me were having healthy, full-term babies by the dozens. I had training as a birth doula, and had attended a few births. I had a strong head about what I wanted and what I didn't want. I thought I knew so much. I wanted a home birth, all natural and beautiful, with no medical intervention at all. I wanted to do it the way women have been doing it forever. I wanted to prove my strength as a magnificent woman, made to give birth. I researched and read everything I could get my hands on.

I skimmed past all of the information about preterm labor, prematurity, birth defects, and disabilities, because it never crossed my mind that that could happen to me. And then it did.

My experience with the birth of Holland and Eden completely changed everything in my life. It changed my entire world view. It has made me a wholly and completely different person than I was before, and would ever HAVE been if things hadn't turned out the way they did. For better AND worse.

Our approach to this pregnancy has been very obviously different. No more visions of natural homebirths, bliss, and invincibility. More like the opposite. Very medicalized, closely monitored, and worried beyond belief about Every. Little. Thing.

I had 3 early term (prior to 8 weeks) miscarriages before I got pregnant with H and E. So this time around I worried incessantly for the first 8 weeks that I would miscarry. Once I got to 9 weeks I started to feel a wee bit better in that regard, but then all of the pregnancy symptoms set in. Nausea that lasted most of every day, extreme exhaustion, moodiness, and guilt for not being able to keep up with my normal daily activities. John and I had decided not to share the news with anyone until after our 12 week scan. John has been going through his own stress and angst over the whole pregnancy thing. He did not want to talk about it. So...I was dealing with it all pretty much on my own.

Then came the 12 week scan. I allowed myself to get all giddy about finally telling everyone and worked out different scenarios in my head for how we would go about it. Because of course, I was completely expecting that the 12-week scan would be normal. And then it wasn't. Sigh. As if the looming possibility of extreme prematurity repeating itself weren't enough for us to deal with.

The 12-week scan showed a slightly increased nuchal translucency (2.8), and "possible" septation, which "could" indicate the "possibility" of cystic hygroma. "If" there is a cystic hygroma, then there is a greater than 50% chance that the baby has a chromosomal abnormality, and if NOT chromosomal, there is an even greater possibility that there is some other genetic abnormality - most likely of which is a heart defect. All of this prefaced with a GREAT BIG "maybe" and all of the wind gone out of our sails. Just like that.

Again I ask myself the question, "Is knowledge power, or is ignorance bliss?"

I spent the next 6 days crying and arming myself with more knowledge. Next step, CVS scheduled. I didn't want it to go this way. Weighing risks, agonizing over these kinds of decision. What to do? We meet with a genetic counselor, sign consent for the CVS, and have another ultrasound. This ultrasound looks perfect. NT is normal, NO septation, and no cystic hygroma. Again the question. To do the CVS or not? As life would have it, we didn't have to make this decision because my placenta was located in a position as to make the CVS impossible. Couldn't do it. This doctor says, "If you came in off the street today for your 12 week scan, I would say Everything Looks Good, and send you on your way." But, we can't discount what the first doctor saw the week prior...still have to consider those results...yadda yadda yadda. Next step bloodwork.

Blood work comes back normal. Finally. Something positive.

I start feeling better physically around 14 weeks. Another positive.

Then we go in for another scan at 15 weeks. Here we go again. Choroid Plexus Cysts. Most likely normal, but considering the results of the 12 week scan could be blah, blah, blah. So now what?

With much trepidation we decided to go ahead with an amnio. This was done at 16 weeks. Emotionally difficult, but physically not bad. Detailed ultrasound done prior and everything looks and measures great, no other markers for any abnormalities or problems. Amnio goes smoothly. Results are normal. Good news.

Started 17P hydroxy progesterone injections at 16 weeks, and will be getting them weekly through 36 weeks. Biweekly (at least they are supposed to be biweekly) cervical measurements also started at 16 weeks.

At 18 weeks I started feeling abdominal pain, cramping, discomfort, -not exactly sure but these could be contractions- type pains. On March 30, I made my first trip to triage and was diagnosed with a UTI. 10 days of antibiotics, infection cleared up. Back at doctor 5 days later because still have these uncomfortable feelings. They check my cervix again. Cervix still looks good. High, closed, and "hard-as-a-rock." "It's a beautiful cervix," they say. But I still have a hard time believing them.

I will have a scheduled c-section between 36-37 weeks due to the fact that I had a classical incision (vertical rather than horizontal) with H and E. The risk of uterine rupture is too great for me to go beyond 37 weeks. The high-risk doctor said last week that she "fully expects" me to go the full 36 weeks. Last pregnancy was twins. Twins are a "whole different ball of wax."

I really want to believe her.

I am continuing to have some occasional minor cramping and 4-5 this-feels-like-a-contraction each day. Could be normal. I remember feeling these same feelings before I went into labor with the girls. Could have been normal then too.

But I guess I don't know what normal is...


Lindsey: Mama of Andrew, Adam, and Ally said...

Congrats on your pregnancy!

Reading this is like déjà vu. I'm currently 35 weeks with a single (after my 25 week twins). We screened positive for increased likelihood of a chromosone disorder but we ultimately didn't do the amnio so that's still an unknown.We had a cerclage placed at 12 weeks and started 17p at 16. I started taking albuterol tablets around 20 due to contractions and uterine irritability, then around 24 weeks we added procardia. Contractions have been crazy and I've done about 2 months of bed rest and three hospital visits but amazingly it seems like our efforts have prevented any cervical changes. I'm scheduled for a csection next week, I can't believe we made it honestly. I've been a nervous wreck this entire time but am so thankful.

Stay strong, you can do it!! Your cute girls will be great big sisters!


Sara said...

I'm sorry you haven't been able to relax and enjoy things with this pregnancy. I guess once your innocence is lost, it's lost for good. Still, it sounds like scare after scare aside, things are actually going well, so that's good news, anyway. Hang in there! said...

Hang in there. I know how tough it is because we had 24 weekers twins. Sadly lost our daughter but our son is doing great and now 4years old. I have followed your blog since B was in the NICU. :-). Congrats on your pregnancy. A full termer can be done. We made it. Not without bumps in the road but our second son will be 2 next month.

Michelle said...

Thank you for sharing your story with us. I've been following your blog for years, and I am always astonished at your strength and grace. Best wishes to you.

Ann Smith said...

I wish you as uneventful and calm a pregnancy as possible, going forward! I'm sorry you've had these scares but am so glad they've resulted in things looking good! You and John are very brave, strong people. Even if your collective knowledge makes blissful ignorance impossible, I hope the girls can provide some distracting, innocent, excited bliss!

Anonymous said...

Congratulations and a wish that you and the little one will be happy and safe for the next half of your pregnancy. Do you know the sex yet or is that a big surprise?
Regards Mandie

KristieMcNealy said...

Hang in there. You guys are all in my thoughts. I've had two babies since our preemie, and both pregnancies were highly medical and full of stress. I hope you can have some peaceful time between now and the big day!

Danielle said...


You ARE a magnificently strong woman and neither the kind of birth you have or the outcome of your pregnancy can change that. Good luck over the next 15 weeks.

BusyLizzyMom said...

Unfortunately prematurity has robbed of us of any 'normal' pregnancy which is so unfair pregnancy should be such a happy blissful time. We should be happily planning for our babies arrival but instead we are worrying and living at the high risk clinic.
I contracted from the time of conception until both my kiddos were born. The progesterone, drinking tons of water and bedrest helped to keep it from progressing but still it is very unnerving knowing they were what caused my daughters premature birth.
Things will be really stressful as you approach the gestation when your daughters were born so make sure you really stay low key around that time. We had hired a housekeeper who was really helpful and also would get groceries for us.
I found I could finally breath easy at 32 weeks, I was still on modified bedrest but I would go out for a quick errand which was so nice.
Hang in there.

Anonymous said...

Many congrats! Your third beautiful baby, like your first two, is very lucky to have you for a mom.

Heather said...

I am 21 weeks with a singleton and I have the cramping could this be a contraction type pains too. I find that a lot of times they come on when i have been going to hard and not drinking enough water. If I sit, or lay, down and drink some water they go away.

Anonymous said...

Hi Billie - Congratulations on your pregnancy! I know what you mean about "innocence lost". You may not know this but you and your blog were my guiding light when my older daughter was born prematurely in 2004. We had another girl in 2009 and all went well (but we were super-careful and used every medical intervention, test, hormones, etc possible to try and ensure this). I am sure with the knowledge and love you and John are capable of, everything is going to go well. Your whole family is such an inspiration. Now I am heading to your March of Dimes site to make a donation! :) With love and best wishes for a healthy and restful pregnancy! AK from NJ

Taylors said...

Hi Billie,
I know how hard it is to go through a second pregnancy with risk factors. We are also pregnant again (induction scheduled 6/8), and it is hard to silence the worry even though there is so much more cause to celebrate than fret. I wish we lived closer to each other so our girls could be friends, and it would be so wonderful to have someone to ride this out with! I truly hope everything goes smoothly and perfectly from here on out with your pregnancy and your baby -- you definitely deserve it! Take care :)

K said...

Strange though it is, you are having a perfectly normal pregnancy post-micropreemie twin birth. I can easily understand the stress and worry! You are strong, that's for sure, and you'll get through it all just fine, no matter what. Take some time to dance to your favorite music. Movement helps the baby to develop and strengthens the baby's vestibular system.

Anonymous said...

I've been a fairly regular reader of your blog since I had my own very premature little one six years ago. It took us four years to attepmt another pregnancy and I have to say that I know EXACTLY what you're talking about when you say that your innocence was lost. I was terrified from the moment that I peed on the stick and all through the pregnancy, especially when we had a 'failed' genetic screening and then choroid plexus cysts at 20 weeks. We made it through all the way to 38 weeks and delivered a healthy little man who is now entering his terrible twos. I'm thinking of you and praying for peace for you.

Jacqui said...

Billie, I'm sorry but I'm only just catching up on your exciting news. With my pregnancy with Mitch (my youngest), I had the same abnormal results. Early test results were showing rhesus c which is absolutely devastating to a fetus. Long story short, everything turned out okay in the end and I went to 39 weeks before having my c-sect. I was literally starting contractions when they wheeled me down to theatre. I guess when you have the trauma and complications of an early birth, you realise that being one of the unlucky ones is very possible.

All the best to you. I'm glad you've hit 27 weeks but there is still some baking yet to go.