I posted it over in my Jan 2014 board but I think home birth is off, and maybe even natural birth. At my high risk U/S today I was diagnosed with a smaller than normal baby and decreased blood flow in the cord.
I go back Thursday for a second scan and decision. If the flow is still low, I'm being induced possibly this weekend. If it improves?it will be day to day?.I'm off work for now.
Still in a little shock. I don't know if this situation warrants a c-sec. I sure hope not!
Please try to get one of your midwives to accompany you to the ultrasound on Thursday, or at least be on the phone with you. At the end of my pregnancy with Tiven, knowing that my midwife was at the end of the phone was so reassuring. As things were happening, my husband was talking with her and saying, "They should be doing this, and that," and knowing that the doctors were doing "this" and "that" was very reassuring.
Also, remember that an ultrasound is a snapshot. If they don't like what they see, then tell them that you want to have some water & apple juice and a walk around, and come back in an hour to see how things look later. I did that multiple times with both pregnancies, and until the very last time with Tiven when I was at 42 weeks, every other time, things looked better enough at the second glance to go on for a few days.
If they're talking about blood flow in the cord, then make sure they do a color Doppler. There is no other accurate way to measure blood flow in the cord. Ask them what the baby's measurement is, and what it *should* be, and verify that "should be" number with your midwife.
What do they mean by "smaller than normal" baby? Has baby's growth rate slowed? That is definitely concerning but, on its own, it might not be alarming enough to warrant induction at 32 weeks. Is baby smaller than the last measurement? That would certainly warrant careful monitoring, and induction very soon if things don't change. But just as some adults are smaller than others, some babies are smaller than others. If you & DH are both on the smaller side, then a "smaller than normal" baby might actually be *your* normal. Again, it would be something to keep a watchful eye on, but it's not necessarily alarming.
Remember your Informed Consent questions. Write them out on an index card to carry, and make your DH memorize them. I've often said I never loved my husband so much as when he asked the doctor, when things with Tiven weren't looking good, "Is this an emergency?"
Ask these questions, make sure you get answers you trust, and make informed decisions about your care and about your baby that you will feel good about in another year. As much as I didn't like how Tiven's birth went, as much as it was *not* the birth I wanted her to have, when it came down to the nitty gritty of it all, I knew that it was the birth she needed to have and that made it OK.
- Is this an emergency, or do we have time to talk?
- What are the benefits of doing this?
- What are the risks?
- If we do this, what other procedures or treatments might I end up needing as a result?
- What else can you suggest we try first or instead?
- What would happen if we waited an hour or two (or a day or two, or a week or two, etc.) before doing it?
- What would happen if we didn’t do it at all?
And finally, remember that you've been under a lot of stress recently with your in-laws and your commute and everything else. You might just need some peace & quiet & rest! Every day baby stays in utero is equal to three or more days outside the womb, so if the doctors recommend induction, make sure that you feel confident that moving your baby out into this world is worth the risk. It might be better for you to move to the hospital for monitoring for a few days to keep a better eye on baby while not dealing with real life, kwim?
I'll be keeping you in my thoughts!
Last edited by Spacers; 12-04-2013 at 03:00 AM.
David Letterman is retiring. Such great memories of watching him over the past thirty-two years!
I talked to my midwife on the phone yesterday and we see her today to figure things out. I'm pretty sure my care is being transferred to an OB after today though which means the midwife won't be able to be our advocate much any more, but I need to ask more questions on how/when that will happen. The U/S yesterday did use colour doppler but I wasn't even in there to check that (was just checking scars from my septum removal and my fibroids) and she just found it by doing a thorough exam I guess. The U/S tomorrow is at just the regular clinic in the hospital, not with the high risk tech. I'll make sure though that they do a very thorough exam.
As for baby size, she said baby was between 3.5 lbs and 4 lbs. I believe the baby should be over 4 lbs at 33 weeks? But if the baby gains 1/2 - 1 lb a week at this time, I would think I'm still on track?? The doctor wasn't concerned about baby size alone though, she said it was more the cord blood flow that was an issue. Size on it's own would just be monitored. DH and I aren't small people now, but we were both smaller but longer babies (I was 6 lbs, he was just 7 lbs). Baby was measuring about a week behind at my anatomy scans too, but they weren't concerned then either. I have had trouble eating because my acid reflux has been horrible, and I also have very little appetite. I'm rarely hungry which I find very odd. After I lost 30 lbs a few years back, I've been very hyper aware of calorie intake since then. I have been eating a high protein diet ever since then as it worked best to maintain weight loss. I have been eating more carbs while pregnant though, and not worrying about calorie intake or quantities. I was also eating small means all day long and not big meals before, so that is the same which helps (it freaks out MIL though as she doesn't get why I can't each a huge plate of food for dinner!) I'm still worried I'm not eating enough though. I've only gained about 20 lbs….
Thanks for that list. I will make note of it and send it to DH too. I get the feeling this OB is very pro c-sec so it may be a fight. I don't know how it works up here if I want a second opinion as well….
Thankfully they moved out already but the stress is still here. DH's family is very…intense. They like to hover. His mother calls 10 times a day to ask status which stresses me out. I'm not used to having that as my family is not like that at all.
The other thing that stresses me out is that we ordered our crib and mattress in black friday/cyber monday deals, but the crib has no shipping date yet (mattress will be here next week). We don't have any crib bedding yet either! And our washer is broken and no idea when it will be repaired (under warranty) as the parts haven't come in. I need to call them today about that too… That means anything we do have hasn't been washed yet! My sister offered to go out and get me whatever I need, just to let her know (such as a bassinet if baby comes home before the crib ships), if I can't get to a store. Yesterday Walmart was sold out of the pads I wanted so I'm going to hit Target today and get some and some disposable nursing pads to pack. I still need to find a bag to actually pack all these items in! And I need large zip lock bags (sorry…just typing things as I remember).
I'm supposed to rest today too. DH is off work today and tomorrow as well until we figure things out. His boss was very understanding and even drove him home mid-day yesterday because our car was in the shop and wouldn't be ready until after work. Saved him a long bus ride!
I will keep you all posted though when I hear more. I guess it would be smart to bring my packed back with me tomorrow just in case I don't get to go back home?
As for the crib and bedding you have time. If baby comes early they will be in the NICU for at least a few days (Robbie was 5 days) and that will give you some time. If baby is in the NICU do not stay at the hospital all the time, it will be tempting but it drains you. Sean had to force me home at one point.
And rest like you are supposed to be doing.
Sean (38 )
Robbie (8 )
Bailey (April 2, 2011)
"The soul always knows what to do to heal itself. The challenge is to silence the mind." Caroline Myss
DD2 was 4lbs 11oz at 33w5d. She was in the NICU for 21 days. There was a lady there with an IUGR baby born at 36 weeks who was 3.5 lbs. He was healthy and stayed about a week.
For me they were going to induce at 34 weeks and let me see how that worked prior to doing a C-section.
DD1 July 2008 (41w3d)
November 2010 (13 weeks)
DD2 August 2011 (33w5d)
When I was at 36 weeks with Tiven, an ultrasound measured her at NINE pounds and I was advised to induce immediately. I refused because I knew, instinctively, that she wasn't that big no matter what their machines said. She was born at 42 weeks -- six weeks later! -- and she wasn't even nine pounds. Close to it, but not there. I can't recall having any 3rd trimester ultrasounds with Weston but between two midwives and an OB palpating & measuring my abdomen on a weekly basis, we knew he was a good size but none of us ever dreamed he would be 10 pounds, 10 ounces!
At 32 weeks, most of the baby websites say your baby probably weighs between 3.5 and 4 pounds, then they all seem to skip to 36 weeks where they say baby should be between 5.5 and 6 pounds. Since your baby was measuring a week behind earlier in the pregnancy, the stated weight from yesterday would not concern me at all. You don't get a diagnosis of IUGR unless baby is below the 10th percentile, or unless the baby's body parts have more than a 25% size discrepancy. Obviously decreased blood flow would be a big concern, but if that looks good tomorrow there should be no reason why your midwife can't continue care.
Honestly, this sounds like a bad tech to me, someone who either expects her "high risk" clients to want something to freak out about, kwim, so she gives them something to freak out about, or who gets her own kicks from freaking people out over what turns out to be nothing much. There are some really nasty people who do things like that, and if tomorrow looks good, I would say something to yesterday's clinic about that tech. I was with a friend for an ultrasound once and the tech said, "Your baby's heart doesn't look good," which of course freaked my friend out, and then a minute later she said, "Oh, baby turned, that looks better now." My friend gained enough composure to tell that tech to get out and complained about her to the supervisor.
David Letterman is retiring. Such great memories of watching him over the past thirty-two years!
First - HUGS! Second - stay calm, and as focused as you can be at the appointment tomorrow. Take paper/pen to write whatever down you think of asking now and later.
I would take a bag just in case. Don't worry about pads or breast pads, someone else can buy them if baby comes early and you can use the hospitals at first regardless. And baby doesn't "need" a crib either. It's also doubtful at 33 weeks that baby would be coming home right away and I'm sure the crib will arrive before baby is allowed home. BREATHE!
Also, u/s are notorious for being wrong about baby size! Sometimes it's just the position baby is in that messes it up. The only thing that would concern me personally is the blood flow. But I'd be very careful about weighing the risks of a preemie vs. just reduced blood flow.
Hang in there, we're all thinking of you!!!!
Ethan - June 21, 2009
Olivia - December 5, 2010
5w3d - October/November 2012
My Ovulation Chart
Oh gosh! Sorry to read this! I have been away awhile. That is shocking news. I so hope that everything is ok with the baby and they let you bake a little longer. In retrospect I think I also had slight IUGR. Henry was always 2-3 weeks behind. I was anemic. I had trouble gaining weight. He was born 6lbs 7oz and was a week late so was labeled "Small for Gestational Age" so there was a whole protocol for that when he was born. He had the whole meconium issue too. My fluids were low at my 41 week appointment. BUT. They never would have known because they don't do routine sonograms. I only got a sonogram at 20 weeks and then again at 41 weeks because I was past due. But I'm glad, because I think so much of what they see on sonograms is hyped up. My baby although with minor birth issues (meconium, cord compression, born small) passed all his test with flying colors. I really hope that the tech just got a bad reading or something. I know you want a natural birth so badly, so I would ask a bunch of questions before letting them induce. Why did you get a sonogram this late? Was there another issue?
Anyways if you do end up having the baby soon, I wouldn't worry about a crib. My baby is 7 months and just recently moved to the crib.
Good luck! Keep us posted!
Just a bit of an update...
We are still in limbo. Back for another NST and scan tomorrow and then we see the high risk OB again on Tuesday. The hopes are still to get us to 34 weeks, but the on-call OB in triage this past weekend thinks baby is doing more than fine and if he/she keeps up with goods scans we could probably make it to 37 weeks!
We got some clarification too. Baby is overall in the 17th percentile for size, and the IUGR is asymmetrical which means everything is growing the same except the abdomen which is only in the 2nd percentile. This can mean placental insufficiency and baby is redirecting nutrients elsewhere to grow but not gaining any fat in the middle. The consensus though after talking with everyone in my family is that we have very small babies. No one in my family has had a baby that made it to 7 lbs. I was overdue/late and I was only 6 when I was born! So the small baby part is probably normal for us. The small abdomen part may be genetic too as my sister had the same issue with her baby 2 years ago and she had to be induced at 34 weeks (but for IUGR AND severe pre-e). He turned out to be fine.
Just a waiting game at this point. I'm so frigging bored on bed rest though! My hands are useless due to numbness and pins/needles that I can barely type, let alone do anything like read or craft! Uggggg…..
Lurking Nana here-
So sorry about the boredom part. You'll wish you had that later on! In the meantime, can you sing, talk to baby, listen to talking books...chat on the phone?
Leo (3 1/2) with Malcolm the cat