Pregnancy Update: 20 weeks

I had my 20 week ultrasound today.  I was thankful that the baby looks healthy and is measuring consistent with her “due-ish date.”  Yeah . . . her.  This is my fourth and final baby.  This is also my fourth and final baby GIRL.  My poor husband.

Many concerns were ruled out today.  At my “advanced” age, and after several losses, and after three perfect children, I was sort of anticipating something “different.”  Different, how, I wasn’t sure.  But I wasn’t feeling like it was going to be different good.  The previous indication of an anterior placenta was wrong – my placenta is high and posterior.  I’m thrilled.  All of the measurements were good.  Nice looking spine.  Nice looking skull.  Nice looking upper lip.  Nice looking kidneys and stomach.

So, as far as I’m concerned, I’m done with obstetric care unless something develops that necessitates that type of care.  I can’t wait to talk to my midwife!

Bellydancing a Better Pregnancy

Oh bellydancing . . . where have you been all these years?  Of course I’ve known about bellydancing, but I don’t fancy myself the bellydancing type, so I’d never done it.  In fact, the last time I saw someone bellydance – and this is going to sound horribly judgmental – I was somewhat traumatized by the woman’s body.  She was one proud mama, I’ll give you that.  But it was just more evidence that I am not meant to bellydance, and certainly not in this town.

This is a very different pregnancy for me.  I’ve thought I’ve had different pregnancies before, but I can honestly say that I’m making this one different.  Those of you who follow this blog with any regularity know that I have posted plenty of academic pieces full of statistics and analysis.  But that’s not my path this pregnancy.  Of course, I’m trying to keep up on all of that – but I’m more interested in building trust, faith, strength, and peace.

So the short of the long of it is I decided to look into bellydancing.  After much deliberation, I decided to purchase Amira’s DVD.  It’s not the most exciting DVD, but it feels amazing.  I rely on my chiropractor to put my aching pelvis back together on a regular basis.  However, since starting the bellydance DVD and alternating it with prenatal yoga DVDs, but pelvis has stopped yelling at me so much.

I also suffer from symphasis pubis dysfunction.  I know the aches and pains are coming, but I’m sure they started earlier at least in the last pregnancy.  Other than some pulling in the left round ligament, I’ve had very little pain in the front.  I’m also noticing now that my adhesions don’t hurt – they sure did when I started the DVD.

If you suffer from pelvic instability – you MUST try bellydance.  I don’t know why this isn’t emphasized as strongly as yoga, but it has made a world of difference for me.  Next up, Dance of the Womb, which you can purchase through ICAN, and actually it’s the best price I’ve found.  I’m also going to try and work a beginning belly dance class into my schedule.  I’ve checked with the teacher, and she says this particular class is safe for pregnancy.

Supplementing Pregnancy with Progesterone

It amazes me that OBs can still be resistant to testing for progesterone deficiency and treating it.  After two consecutive losses and a clean blood panel, I begged my OB to test my progesterone levels.  I was pregnant again.  Not only did she refuse to test, but she also said that even if I tested low for progesterone, she wouldn’t supplement.  Her “brilliant” idea to treat pregnancy loss was Clomid!  (You can read tons of stories about women taking Clomid and suffering miscarriages as well as being blessed and challenged with multiple gestation issues.)

I lost that baby at 10 weeks gestation.  It died a few weeks earlier.  I was devastated and so angry.  I’m still angry at that nutjob OB.  For numerous reasons I transfered to a more compassionate OB who had been through infertility with his wife and also seemed to enjoy thoughtful discussions with his patients.  Although he misdiagnosed my problem, he supported me in seeking a second opinion with a reproductive endocrinologist (RE).

The RE discovered low low low progesterone.  The RE also found adenomyosis in my uterus that was distorting the shape of my uterus.  He believes that my cesarean caused the adenomyosis.  He removed as much as he could.

I received the all clear to TTC and quickly became pregnant again.  (Becoming pregnant was never my issue.)  I began supplementing with progesterone via 17-hydroxyprogesterone shots.  An early ultrasound discovered that I was carrying twins.  (Recall the one OB’s suggestion to give me Clomid?!??!!!!!!!)

I continued the progesterone injections and weekly progesterone tests during the first trimester of that pregnancy.  My progesterone levels seemed ok on their own, but it was prudent to continue especially since specialists don’t know what a good level of progesterone is for multiple gestation.  After three consecutive losses, I carried my twins to term. :)

I accidentally became pregnant during my September 23, 2010 cycle.  I suspected it almost immediately after conception, so I began early testing.  By CD 28 I tested positive for pregnancy.  I contacted my OB’s office (my previous lovely OB died the day he cleared us to TTC in 2008) on a Friday, and was frustrated that it took until the end of the business day on Monday to get a script.  In the meantime, I contacted medical friends and even the RE’s nurse.  I was amazed that she got back to me and was still willing to advise me . . . 2 years later and from out of state.  What a blessing.

Your typical OB isn’t always well-equipped to deal with early pregnancy issues.  My OB recommended 100mg oral progesterone.  I double-checked this with the RE’s nurse, and she did NOT recommend this treatment.  My SIL also told me some sketchy stuff about oral progesterone supplementation.  The RE’s nurse said the best thing to do is either go back on the shots or do 200mg prometrium vaginally.  Since prometrium is so accessible and doesn’t require a stick in the bum, I went that route.  I also want readers to know that it took a while to straighten out the script, but by Tuesday I had what I needed thanks to a lovely independent pharmacist, the RE’s nurse, and the OB’s office following through with exactly what I requested.

I just want to offer this information up for those who are struggling to make sense of their losses.  Really, if you think you suffer from low progesterone and/or a short luteal phase, you need a medical script for progesterone supplementation.  It is unlikely that natural supplements will do the job . . . maybe for marginal progesterone?

Someone on one of my advocacy lists said that taking prometrium vaginally seemed “iffy” to her.  I must admit that irritated me, but she doesn’t know anything about me or how seriously I consider my health decisions.  Had I not been directed to this reproductive endocrinologist in 2008, I would probably not have my twins or be 16 weeks pregnant with my fourth and final baby.

Fiction gives me unexpected confidence

This may sound strange, but I’m reading Dan Brown’s The Lost Symbol at my husband’s suggestion, and it’s really helping me . . . at this moment . . . find peace with my path to successful birth at the end of this pregnancy.

This book introduced me to noetic science.  Huh?  According to Wikipedia, noetic theory is “the study of mind and intuition, and its relationship with the divine intellect.”  That is just right up my alley in some ways.  I’m more prone to read a research study about pregnancy than I am to delve into Birthing from Within, but part of my non-fiction pursuits in the past have focused on theology and mysticism, and this book (and a recent talk with a trusted friend, a “straight up” talk with a midwife who doesn’t live in my area, and some soul searching) has helped remind me of the mystical aspect of birth.  Birth is a divine gift and one bestowed on women.  Should it surprise us that the male-dominated world would try and rob us (think gender subversion, think hegemony, heck think Marxism) of this unique gift?!

Ok, so back to my unexpected fiction-induced fervor and confidence in my ability to birth:

  • “Our untapped potential is truly shocking.” (p. 27)
  • “We have barely scratched the surface of our mental and spiritual capabilities.” (p. 67)
  • Our thoughts have physical mass & can interact with the physical world, “. . . whether or not we [know] it, effecting change all the way down to the subatomic realm.” (p. 67)
  • Intention requires practice! (see http://www.theintentionexperiment.com/how-to-intend)
  • This seems to coincide with what I’ve already learned about Bodytalk (see http://www.bodytalksystem.com/learn/bodytalk/) – that the body can rebalance and repair itself.

Gosh, what does this have to do with natural birth?  Well, in my case, I’ve had a lot of experience with programming myself in the medical model of women’s health.  I have benefitted from this model, surely, but when it comes to natural physiologic birth, the medical model has its severe limitations.  I feel like a hostage to the medical model – and sometimes victims are oddly attached to their captors.  I am one of those victims.

I need God to work with me BIG TIME during this pregnancy.  He continues to keep me safe even though I fall flat on my face every day.  He never forsakes me.  He will protect me and this baby too, if it’s his divine Will.  God’s plan may not be my plan, but I have to believe that no matter what my and my husband’s decision may be for this birth, that His Will will be done.

“Lo, children are an heritage of the LORD: and the fruit of the womb is his reward.” ~ Psalm 127:1

“Peace I leave with you; my peace I give you. I do not give as the world gives. Do not let your hearts be troubled and do not be afraid.”  ~ John 14:27

“Commit everything you do to the Lord. Trust Him, and He will help you. Be still in the presence of the Lord, and wait patiently for Him to act.” ~ Psalm 37:5,7

Clearly, I’m still working all of this out and how it connects, and how it may or may not be useful to me.  But I am excited to share this renewed faith with you.  I’ve always been interested in the spiritual aspect of science, and now I’m discovering even more connections to and evidence of God’s presence in modern science.

Here’s to a peaceful and powerful 2011!

Excited and then NOT

It’s amazing the span of emotion I have experienced this past week regarding my pregnancy.  I love being pregnant – LOVE. IT.  No bones about it.  There is something just so special about carrying a little baby so close to your heart, blossoming over the weeks and months, and feeling those kicks and twists.  I love it all minus the intense pelvic discomfort thanks to SPD.

This week has been bizarre.  Or maybe the last two weeks have been tough.  You’re dealing with stressed out students, stressed out colleagues, too many performances and events to attend, too much grading, and your own life on top of it all.  Then you hit finals week and performance juries, and you’re dealing with stressed out students and being tied down for hours on end, not getting your grading done.

I think I tend to accumulate other people’s stress . . . as if I’m not prone to carrying around plenty of my own?!  And then the doubts start sneaking in.

WHAT IN THE WORLD am I doing having another baby?

If I think I”m stressed out NOW, think about how bad it will be this time NEXT YEAR?

Where are we going to put all of these children, and how are we going to provide for them?

If something is wrong with this pregnancy, it’ll be a blessing in disguise!  (I’m actually disgusted with myself for ever thinking this, especially everything I’ve been through in the past years.)

I’ve been reading blogs and birth stories this morning, and I’ve found my excitement again.  Thank goodness for that.

I have an OB appointment tomorrow, and I’m counting on hearing a beautiful strong heartbeat.  My husband can’t go with me, so I’m a bit nervous.  Until I start feeling movement, I just have to trust that everything is ok.  That’s tough, especially when you’ve had a late loss.

I’ll have an update tomorrow, I’m sure.

Breaking up with OB?

So, if you read this blog at all or know me, you know that I had an unnecessarian in 2004 for “CPD.”  (Umm, I’m 5’10” and only had an 8lb baby.)  I suffered three consecutive first trimester losses.  I had a repeat cesarean in 2009 for double footling breech twins.  And now I am pregnant again with a singleton and planning to HBA2C in June or July.

So, my childbirth years have been heavily governed by the medical model of care.  I’ve been wanting a homebirth since 2007, but the opportunity evaded me until now.  I need to break up with my OB, and if you have any suggestions for when and how, I’d love to hear from you.

Should I wait until after the 20 week ultrasound?  (I want this ultrasound to confirm where the placenta has attached.  I already know that it is anterior, so I am concerned about accreta.)

Or should I do it now that I’m out of the 1st trimester?  I already have a relationship with a midwife and will be seeing her in the next couple of weeks.

I see benefits for doing it now and for waiting.  If I do it now, I have more time to trust my body, my baby, and my midwife without the temptation of ultrasound machines and other interventions.  I’ve become somewhat dependent on the “bells and whistles” of obstetric care, and I don’t think they help me build that internal trust I still lack. 

These are just the 8am Saturday morning musings of the over-thinking fence sitter!