Tuesday, 29 July 2014

The world has started slipping

You know what? Two weeks ago I was feeling calm and happy and totally sane. Pod being in a breech position tipped that a teeny bit sideways, but didn't totally shake things; there was still a good chance she could turn or be turned (even though she was in an unlikely position). But this week I'm definitely wobbling. 

Went for booking appointment at Kaleeya hospital yesterday, routine thing because it's our back up and where I would be transferred if required before/during/after birth. I saw an obstetrician who gave me a once over and the following news:

  • Pod is still breech (this we knew, I can feel her head to the right of my tummy button and it hurts like fuck when she dances on my cervix)
  • I have low amniotic fluid (my uterus isn't as big as it should be, there's a void under my ribs, my tummy is all baby and no swimming pool)
  • Pod is measuring 28/29 weeks rather than 32
  • We have suspected IUGR (intrauterine growth restriction - or retardation if you're American or insensitive)

This means that (for now) our care has been transferred to the hospital (our normal midwife is away this week but I have to remember to talk to her about shared care. If everything turns around, including Pod, and I become low risk again then we can still have an unmedicated homebirth as planned). I'm going back early next week for a growth scan to see how much/little fluid I have and how big/little Pod is.

So now we have more possible outcomes than we did before:

  • Fluid level climbs, Pod turns on her own into a good position and doesn't have IUGR = homebirth
  • Fluid level climbs, Pod is turned by ECV, stays head down and doesn't have IUGR = homebirth
  • Fluid level climbs, Pod stays footling breech, no IUGR = cesarean at 39 weeks
  • Too little fluid for Pod to turn, no IUGR = cesarean at 39 weeks
  • Way too little fluid, no IUGR = induction or cesarean earlier than 39 weeks
  • IUGR = monitor Pod very closely, try to determine cause of IUGR (fluid/infection/placenta/genetic or other defect), depending on severity possible cesarean at 36/37 weeks (I think they'll let her cook until they feel she'll do better on the outside)

Right now it feels like a lot has to come good in order for us to achieve a normal birth with a healthy baby. Google is a scary place again with this latest acronym in my hands. I've known for ages that Pod's in a weird position, and that her head seems to be right against my skin without much cushioning, and that there's a big hole between my ribs and where I feel like the top of my uterus is, but we've been told until now that even though I look small, she's the right size. Now suddenly she's probably not the right size, she's possibly stopped growing or her growth has slowed so much that it's a problem. 

I tested negative for the common infections that can cause IUGR, I don't smoke, drink or take drugs, I don't suffer from malnutrition, advanced diabetes, high blood pressure, kidney or lung disease, or sickle cell anemia, and there's only one baby in there. So this leaves 2 possible causes for IUGR (if that's what's happening): a problem with the placenta, or chromosomal defects in the baby.

Low amniotic fluid could also be due to a problem with the placenta or a problem with the baby (kidneys, urinary tract, heart or chromosomal). I don't think I'm leaking fluid, and I'm not taking any medications so that's not why.

So now when people say "OMG you're so small" I want to cry and punch them in equal measure. HN1 is trying not to be worried, and he's right when he says there's no point stressing about what might happen. We need to get to the scan and go from there. Although it doesn't hurt to think about what might happen - I mean, wouldn't it be worse if I just kept skipping through the wildflower meadows with my face towards the sky, dreaming of rainbows and planets, and then all of  a sudden we get to the scan and it's bad news? I don't know. I'd rather be a tiny bit prepared for an IUGR diagnosis in case they do want to snatch Pod out of me sooner rather than later.

Whatever happens, now there are lots of those feelings things happening (aside from panic). I feel scared that there's something wrong with my baby, possibly something that can't be "fixed". I feel inadequate and like I haven't done this job well enough, that my placenta and I aren't good enough. I feel guilty in case there is some sort of infection I've passed onto her, or in case my predominantly vegan protein intake hasn't been enough to sustain her growth. I'm anxious that the position she's in now is due to my uterus not being big enough or containing enough fluid to cushion her or allow her to float in peace - instead she's squished up against the outside world with not enough protection. What if she's uncomfortable???? 

I can't just stop feeling these things - I imagine I won't stop feeling them until we're told that Pod is fine and strong and healthy. Hopefully this is what they'll tell us next week. I REALLY want the scan sooner but it's a public hospital and we have to take what we can get. Trying to find a private hospital with a good OB this late in the day in Perth would be pretty impossible. Plus I'd like our homebirth option to remain open should everything turn around, and we chose Kaleeya as our backup because they're midwife run and into normal, natural birth.

Trying to get my head around a c-section too. If it's best for Pod, OF COURSE I'll have one. Though I worry about what we'll be missing out on - not that I'm anti-intervention; when it's necessary it's necessary, I just don't want it. I want the labour and the hormones my body would release and I want Pod to have those that her body would release, I want that journey with my baby, I want delayed cord clamping, I want to birth my baby, not have her pulled out of me before she decides it's time. None of that sounds like me, it all sounds way too crunchy, but I worry about the effects of a medical birth full of drugs and lights and surgeons vs a calm, natural birth. I might not want to eat my own placenta or deny my child vaccines, but I do want the most natural possible start to life for Pod, and the most natural start to our lives together.

Then I feel like a dick because actually what matters is that she arrives, not how she arrives.

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