Wednesday, May 18, 2011

Single Digits!

We're down to six days to go! Bags are (mostly) packed, the nursery is (mostly) ready to go, and we might even have a nanny lined up soon. The best news is that Asher's non-stress tests continue to look great. We had one final ultrasound yesterday to check his fluid and umbilical cord blood flow, and it was excellent. Phew! Seems like we might actually make it to term!

After nearly five weeks in bed, I am dying to get mobile again. There is only so much TV you can watch, and after the first few days, the antsiness takes over and precludes any sort of productive activity. I really wonder how anyone did this before the internet, TiVO, and Netflix. And online shopping has been a godsend--it's wonderful that Amazon has such great deals on those last-minute baby things (and free 2-day shipping if you register for Amazon Moms!).

The strange thing is that because I'm so anxious to get out of this bed, I forget a lot of the time that getting out of bed also means getting a new baby. I was thinking the other day that bedrest is a very good reason to find out a baby's gender. When you can't "enjoy" the last few weeks of pregnancy with all that nesting, baby showers, hanging out in the nursery, etc., it can be hard to feel connected to the baby. I can't imagine how much harder it would be if the baby were genderless and nameless. I've always hated calling fetuses "it" when my patients don't want to know the gender, and it really makes me wonder how you prepare emotionally when the gender is a surprise. I realize that for centuries women have survived pregnancy without knowing the gender, but given the situation, I feel very fortunate that Asher has been a real person to us for months already.

Of course, we have so many surprises waiting for us in a few days. Despite all the 3-D ultrasounds we have done (one of the advantages of having your own, brand-new ultrasound machine), we still wonder what Asher will look like. Around 28 weeks, he looked just like Crockett and our nephew Aldo. More lately, we're not so sure. He definitely has Dunn lips, but sometimes I think he might have a little Marki and Brown (my mom's side) in him after all. Probably the biggest question for me is what his hair will be like--Dunn babies are blond, ours are brunette. Like I said, we still have so much to learn about this little boy!

For now, fingers crossed for an uneventful six days and a safe and uneventful delivery on the 24th. Next post, maybe we'll have some new pictures to replace that 28-week ultrasound!

Thursday, May 12, 2011

Out, Out, Damn Placenta!

My crummy placenta strikes again!

I was fortunate to be able to return home last week, after 11 days in the hospital. It's been wonderful to be in my own space and reunited with my furry kids. Since I've been home, we haven't any more labor or abruption scares. Crockett was quite certain that we'd be back in the hospital within a day or two, and I am happy to have proved him wrong.

Unfortunately, it seems that my placenta is continuing to misbehave. We had our last ultrasound to check Asher's growth yesterday, and he is definitely starting to show evidence of growth restriction, indicating that he is not getting what he needs through the placenta. He currently in the 15th percentile for size overall, which is down from 24th in the last 3 weeks and puts him right at 5 lbs. He is not technically growth restricted because that diagnosis isn't given until babies dip below the 10th percentile, but the trend is concerning. Even more concerning is the distribution of his growth: his head is continuing to grow at a normal rate, but his abdomen is measuring a 2-3 weeks behind schedule, which is the pattern we see in babies whose placentas are not functioning well (it's called "head-sparing" or "asymmetric" growth restriction). This pattern of growth indicates that he isn't simply a small baby, which you might expect given my tininess, but that this is actually a pathological change in his rate of growth. The one bit of good news is that so far, he doesn't show any signs of the distress that can occur with poor placental function.

None of this is particularly surprising to us. From the beginning, we have known there was a high likelihood of this happening, given my chronic high blood pressure and abnormal first trimester Down syndrome screening results (that darn low PAPP-A level strikes again!). But it is disappointing because it is just one more thing to worry about, and from a maternal standpoint, I feel awful that my poor baby is figuratively starving and there is nothing I can do about it right now.

All of that said, this doesn't change the plan for the next couple of weeks at all. I will continue going in for fetal monitoring a couple of times a week, and delivery will still be at 37 weeks, so long as testing remains reassuring. We have a c-section scheduled on May 24th at 9:00, which happens to be our 8th wedding anniversary. I can't imagine a better anniversary gift! (I mean the baby, not the surgery.)

For now, I just hope this crummy placenta holds up for the next 12 days, but I won't be at all surprised if it doesn't. And whenever delivery happens, I will be ready and SO very happy to be separated from this stupid placenta once and for all!

Tuesday, May 10, 2011

Desperately Seeking Mary Poppins

The one very good thing about being off of work longer than expected is that I have had plenty of time to work on finding a nanny for the little one. I'm planning to return to work mid-July, which means that Asher will be about 8 weeks old when it comes time to entrust him to a stranger. We do feel very fortunate that Crockett works from home and will be around in case of any emergencies and has some flexibility if our nanny arrangement does not work out. Plus, no need for a nanny cam! But I have no idea how I would find time to sort through all the applications we're receiving if I were working full time.

The nanny search has been interesting thus far. We have found a couple of great-sounding candidates and are interviewing one of them today. However, we have also run across some doozies, which has raised a lot of questions for me about the intelligence of job-seekers in the area. Some of my personal favorites include a woman who said she had a lot of experience with kids because she babysat her friends' children on occasion (her real jobs have been in other areas) and another whose resume only listed jobs at car dealerships. It has also been interesting to see what some people's concept of a "nanny" is; one woman said that she would like to be Asher's nanny but that she needed to watch him out of her own house (and we would have to drive him there and pick him up) because she needed to be home to take care of her SIX children as well--not exactly the one-on-one attention we were hoping for him to receive in the first few months of his life.

In the long run, I'm sure we'll find a great arrangement. But it is a real challenge for me, as a planner, to remember that it might not work on the first try. Maybe we'll get lucky. For now I'm keeping my eyes open for carpet bags.