Tuesday, October 28, 2008


The report on my cervix from the midwife today is still closed, long, and soft. No cervical changes and no meds since Saturday means I'm going to try to go back to work on modified duty (sitting only) a few hours/week starting next week. Nobody wants me to start contracting again, but I'm feeling pretty good and think a change of scenery would be nice. If my uterus starts acting up again I can always come back home.

This weekend was a little bit of a trial run. I got the go ahead to be up and about more than I had been. MM and I went to a movie (W.--worth seeing) and I went out with a girlfriend to a local baby store. I tolerated the outings pretty well, so feel good about trying a little work.

I'm past the 30 week mark and looking forward to 32!

Saturday, October 25, 2008

Happy Day

Things are looking up for me and the little one. I didn't need to take my Nifedipine at all yesterday as the contractions have slowed down considerably. In other good news, I got a negative fetal fibronectin!!! I wasn't expecting it to change, since we were testing so close to the first, but I'm so happy to have this piece of reassuring news. This means the chances of a delivery in the next 10-14 is days very low, which means I'll probably make it to at least 32 weeks. Needless to say I'm thrilled! This also means I'm free to go to a movie this weekend and try being up a little more. If everything is still OK at my appointment on Tuesday I may even be able to go back to work on a very part-time basis.

Thank you so much for your calls, visits, comments, and thoughts during this time of uncertainty. I really appreciate it.

Tuesday, October 21, 2008


The last few days have been fairly uneventful--as it should be. I haven't been to the hospital since Saturday, and my cervix was essentially unchanged on exam today. I'm still having contractions, but not very regularly.

I'm doing everything I can to keep my baby safe inside, but the outcome is out of my control. I have probably mentioned before that as a rule, I'm a planner. This whole thing has changed a lot of plans already. The uncertainty and anxiety can be difficult to handle. Will I be able to go back to work? Will he come early? Will he be healthy? It's hard to put these questions aside and just be with myself in the moment. It's also hard not to feel let down by my body. It wasn't enough that I had such a hard time getting pregnant, now my uterus may be trying to get rid of this kid before he's ready. What is wrong with me!

I know it's pointless to go down this road. There's no way of knowing what is really going on in there. It's all a mystery. We take it as it comes.

As for the update on me and my sedentary life, I'm thinking about doing some admin work from home to help keep my mind engaged and help me feel useful. So far I've finished a knitting project, read a book, talked to lots of friends and family, scoured craigslist (I'm kind of an addict), organized some old photos, and thought a lot about my little boy. Nothing else is new. My OB might repeat the fetal fibronectin on Friday, but if everything stays quiet I shouldn't have any more exams or appointments until then.

Oh, one exciting thing is we have a friend coming over to the house tonight to take some pregnant pictures of me and MM. I figure now is as good a time as any. I'll post some in the next few days when I get them back. I'll try not to look too gross and bed resty.

Friday, October 17, 2008

Not Reassured

By yesterday afternoon/evening my contractions had really slowed down and I was just sure that my fetal fibronectin test would come back negative today (negative being good this time). I was wrong.

MM and I went in this morning for the test. My cervix hadn't changed, so I went back home to wait. I sent MM off to work and a couple of hours later my midwife called. I could tell from the tone of her voice that the results weren't what we had all hoped for. She said I should come in for my betamethasone injection (to mature baby's lungs in case he comes early) and to be monitored. She asked if MM was home, when I told her he wasn't, she offered to come to the house and pick me up. I think she could tell I was kind of loosing it. I called MM, told him the story, packed a few things to keep me distracted in the hospital and waited for my fairy godmother of a midwife to come and get me.

In case you're feeling jilted because your midwife/doctor never came to pick you up from home, I should let you know that I'm getting my prenatal care from the clinic where I work. I'm an NP on the Family Medicine side, but have a great relationship with the OBs and midwives. Sometimes it's nice to be a VIP.

Once we arrived at the hospital, I got hooked up to the monitor and proceeded to start contracting much more frequently than I had been at home--like 5 X in 10 minutes. That was enough to get everyone a little unnerved, so I got a shot of terbutaline to settle things down on top of my regular nifedipine dose. That seemed to do the trick, but they still had me stay for several hours to keep an eye on everything.

Baby Boy didn't seem to mind. He's still movin' and goovin' in there, and his heart rate stayed stable during the contractions, although we both got a little tachycardic after the terbutaline--that stuff is strong.

The OB came to check my cervix again before she let me go. The report is closed, long, and soft. All good except for the soft part, but I'll take long and closed any time.

I'm back home now on modified bed rest. I won't be going in to work for at least the next 2 weeks, which I really wasn't ready for, but it is what it is. I'll do whatever I need to to keep my baby inside for as long as possible. We'll go in tomorrow for the second shot of betamethasone. The OB said the weekend will be critical. We should know more what direction things are headed by Monday.

So that's the story. I wish it was a different one, but it's mine, and it's still not so bad. My baby is healthy and growing inside me, my cervix is closed and long, and my "bag of water" is intact. All things to be happy about.

Thanks so much for sharing your well-wishes and happy-ending stories. It really does help. Now, any fabulous ideas for passing the time while on bedrest?

Wednesday, October 15, 2008

Sleepless Night

This morning around 4 AM, I thought we might be meeting our baby boy sooner than we hoped. I woke up last night around 3 AM with steady, regular contractions. They weren't painful, but weren't letting up either. I drank half a liter of water and laid back down. Still no dice. After about an hour, I called the OB, who suggested I come in, get monitored and checked.

Once I got up to the OB floor the monitor confirmed what I had been feeling--I was having regular contractions. When the OB came in to check my cervix I was already pretty freaked out. I had noticed a little bit of fluid leaking, so one of the nurses did an amnio swab that looked positive for amniotic fluid, indicating premature rupture of membranes. If you're reading this and you don't know, when your membrane breaks, you're having the baby within a day or two one way or another. As happy as I was to make it to my 28 week goal, I was still not ready to deal with a pre-term delivery. I was very relieved to find out that lots of things can give you a false-positive amnio swab, and upon further investigation (sterile speculum exam and ferning test) it looked like my membranes were still intact. As far as the other labor markers, it was mostly good news. Even though I was having regular contractions, my cervix was still closed and about 3 cm long. It was getting a little "mushy" though (starting the effacement process). I was given a dose of Nifedipine to help stop the contractions, and stayed on the monitor for several hours.

The ultrasound tech came in and did a formal ultrasound to check my Amniotic Fluid Index (AFI) and fetal weight. It was fun to see him again--and yes, it's still a boy. He weighs right at 3 lbs and my AFI was 18--also good. My blood work showed that I am anemic (yes, I had been slacking on my supplemental iron), but otherwise fine. No signs of infection and no clear cause for my premature contractions. After my contractions slowed to about 1 an hour they released me to go home and rest the rest of the week on Nifedipine every 4-6 hours. The plan is that if I have more than 4-5 contractions/hour I go back to the hospital. If they stay farther apart, like they are now, I will go in Friday morning for a Fetal Fibronectin test. If that's negative, we'll all feel a lot better. Apparently, the negative predictive value of the test is pretty strong. If I get a negative on Friday it means that there is little to no chance that I'll deliver in the next 7-10 days. If it's positive, I may or may not deliver pre-term.

So, it's been an emotional and tiring 15 hours. I was really enjoying the pregnancy and looking forward to the last trimester. Today I had to face the possibility that some of my hopes and dreams for a normal and healthy pregnancy, delivery, and baby might not be realized. I am trying to stay positive. I know that it's possible that this will pass and I'll carry our baby to term, but it's hard right now.

Thursday, October 9, 2008

Birth Stories

This is my 100th post. Apparently this is some kind of blogging milestone. When I started the blog I had no idea how long it would go on (I hoped the IF part would be short and sweet). Fourteen months and 100 posts later I'm writing about my upcoming labor and delivery. Wow.

MM and I went to our first childbirth class this week. We had a hard time coordinating our schedules, but finally found an evening that would work for both of us. The class was at a local birthing center, but is open to anyone regardless of where they plan to deliver. As for us, we have decided to plan for a home birth. The hospital is only 5-10 minutes away if we need to make a move at some point. I've spent a lot of time thinking about this and evaluating my options. I am not against hospital births, but feel like I'll be most comfortable laboring on my own time, however I need to, in an environment where I'm comfortable, and where I know and trust the people around me.

On my recent visit with family I collected birth stories from my grandmothers about their experiences and those of their mothers. It feels good to have great cloud of women who have birthed before me in dining rooms and bedrooms without the benefit of skilled practitioners and technology that is now available to me even at home.

It was striking as I heard their stories to hear the changes that happened over time. As birth moved from home to hospital, there were more problems, more interventions, more "failures". I am not naive about the risks of unattended birth or the complications that often occurred at many of these early home births, but none of the stories I heard ended in death or disability for mother or baby. I understand that interventions are sometimes necessary, but often they are unnecessary and risky.

I know that my labor may not turn out as I hope, that I may end up in the hospital or with a Cesarean, but right now I'm enjoying planning my birth at home. If there are any veteran home-birthers with suggestions/advice I'd love to hear it.

Sunday, October 5, 2008

Casual Traveler

I just returned from my swing state tour (VA, MO, and AR), also known as the end of second trimester, see-everyone-you-need-to-see trip.

When I arrived at the airport, there were new signs at security. The first was for "Families and Special Assistance," the second, "Casual Traveler," and the last, "Expert Traveler." It struck me that this would me my last trip as a casual or expert traveler for quite a while. Apparently once you're traveling with kids, special assistance is required.

I had a great time visiting family and friends. I won't be traveling for the holidays, so it was nice to see everyone now. I got some good belly lovin' on the trip. I also got to hang out with my brother and sister-in-law who is pregnant and due in November. I went to one of her OB appointments while I was there and got to see my nephew on the ultrasound. I wish I could be there to see him when he's born, but I'll be too far along by that time to fly back.

Things are looking good for me in my 27th week. One week 'till my 28 week goal!