When I last had a baby, I was 35 for the entire pregnancy. I met ACOG's technical definition of Advanced Maternal Age, but my OB never mentioned it. Later, at a yearly appointment, I asked her about it. She said that for someone with my medical history and pregnancy outcomes, she would not consider a pregnancy AMA until age 37 or 38 at the earliest.
As my husband and I discerned over the years about whether another pregnancy would be prudent, I always asked my doctor her opinion on my fitness for pregnancy at my yearly visit. She always was unfailingly positive. Someone with my history should not need to avoid pregnancy for medical reasons. As I crept up in age, she would caution that it might take longer than usual to get pregnant and my risk for miscarriage would be higher, but she strongly felt the odds were overwhelmingly in my favor.
Then we made the decision. It did not take longer than usual to get pregnant.
At the beginning of my pregnancy, while I was a spring chicken of 39, nothing much was different from a medical perspective than with my other pregnancies. My appointments were carried out in the same old way. I didn't have any extra appointments or screenings related to my age. I did have more ultrasounds, but that was due to ectopic concerns and later baby hiding from the doppler, but not my dotage.
In May at my regular appointment, my doctor made note of my 40th birthday in June. She said I should get a phone call from scheduling setting up my appointments for the rest of the pregnancy. I was not alarmed by either comment. I happened to get the phone call in a few days at a bad time. The nice woman on the phone said it wasn't a problem and she was just letting me know to expect a list of my third trimester appointments in the mail. Nothing prepared me for what was in that fat envelope when it arrived the next day.
Appointments. Oh, so many appointments. They had me scheduled for three appointments a week for the last seven weeks of pregnancy. Every week starting at the beginning of August, I was supposed to drive into Nashville for an ultrasound to check fluid and growth on one day plus a regular appointment and then drive back into town another day for a separate non-stress test. I was astounded. I went from being treated like a normal pregnant woman who had been encouraged to pursue a healthy pregnancy to one who it seemed they feared might have catastrophe strike if they didn't see me every few days.
Taken aback by this pile of appointments, I did some research to figure out why so many. (Let's be real, I asked people on FB and then did some other reading aside.) It turns out there is a higher risk of stillbirth in the last couple weeks of pregnancy for mothers over the age of 40. And I guess that's me now. I am frustrated by the notion that if I had had this baby in June instead of September, I likely would have been scheduled for almost none of this.
But the last couple of weeks of pregnancy is a far cry from the last two months. I have other things to consider besides tests being run out of an abundance of abundant caution. First is child care. Where am I to store the other children while I attend appointments that will carve three to four or more hours out of my day twice a week for seven weeks? The second is cost. Being the proud owner of a $5200 individual deductible before the insurance kicks in at a generous 50%, these tests will cost me upwards of $300-$400 a week. That's a pile of money. (How much does an NST cost? Anyone know? Not me.) I have no desire to spend that kind of money without a real reason to be doing it.
At my next appointment I talked to my doctor about my concerns. She explained the elevated stillbirth risks, but agreed that given my health and history, I could postpone these tests a few weeks without much concern from her. She wrote up the order to cancel two week's worth of appointments and I took that trusty piece of paper down to a scheduling nurse.
The scheduling nurse was beside herself. How did I manage to get the doctor to agree to cancel these appointments? Not your business, schedule nurse. She just wasn't too sure about this. I didn't ask your opinion, schedule nurse. She couldn't possibly reschedule a different appointment I had a conflict with because she was already pressing her luck by cancelling the other appointments. Show me your credentials and your understanding of my medical chart and then I might care what you have to say about this, schedule nurse.
I didn't really expect the scheduling nurse to be the source of friction on this topic, but there it is.
At my appointment earlier this week, I saw a different OB than my usual. My OB was on vacation and that's just the way the schedule worked this week. Whatever. My appointment was entirely normal. Appropriate weight gain. Good, which is to say low, blood pressure. Good fundal measurement. Strong heartbeat. This different OB might have used the word 'perfect' several times during the course of our five minutes together.
Then, apparently? something? I don't know?, she must have noticed that I was officially old on my chart. OLD, I tell you. After telling me how wonderful it all was, she then asked if I had an appointment scheduled with the high risk OB. Um, no? You just told me everything was perfect, repeatedly. Now I need the high risk OB? Then she asked if I had a growth scan ultrasound scheduled. Yes. When? In two weeks. Okay, good. We really need to get a growth scan on this baby. If you say so. My belly has grown since my last appointment and baby is kicking the fire out of me, but I guess we can't be too sure that baby actually grew. It's all a coincidence. I suspect my regular OB would not have been so jumpy.
So that's life with a really official AMA pregnancy. Everyone at the OB office thinks it's great, but they also think you might spontaneously combust. Stay tuned...
(Digression: I will be having this baby at the hospital this time. The midwife who lived five minutes away moved out of state. The other midwife I wanted to use couldn't guarantee her arrival within an hour. This is totally understandable. The number one medical concern in my pregnancies is unassisted delivery. If the midwife couldn't get here quickly enough, I'd run a high chance of delivering by myself. So the hospital it is. I know this means I will likely be induced. Meh. But it is what it is. The goal is no interstate deliveries.)
Wednesday, August 2, 2017
Sunday, July 9, 2017
Swimming While Pregnant
I have had this longstanding fantasy where I am a swimmer. Somehow the logistics and the schedule and the swimsuit and the stars align and I am able to go swimming on a regular basis for exercise. Add to this fantasy all the stories you hear about pregnant women finding relief in the pool and I was especially excited to see if I could manage this feat during this pregnancy now that the schedule seems like it could be possible. I have spent more than four years pregnant and never found my way into a swimming pool. Until this past Monday.
My sister's neighborhood has a pool and she mercifully invited the entire crew to go swimming with her kids. I found a swimsuit that I could passably wear with my Big Giant Belly* and packed all the children off to the pool.
After getting everyone sunscreened and into the water, I had to figure out how to safely get myself into the pool. The kids were all playing on this side of the pool, but the stairs were on that side of the pool. I didn't trust myself to just plop myself into the water so I decided to walk over to the stairs and then walk/float back over to where all the children were.
Now this isn't an Olympic style pool or even one you might see at a rec center. This is what you might call a hotel style pool. It is a rounded off rectangle with the deepest part in the center of the long side of the rectangle. The two short sides of the rectangle are 3 feet deep that increase to four feet and then hit five entire feet of depth in the center. Since I am about 5'2'', I knew I could walk most of the way and then just float across the five foot center.
I slowly descend into the water and feel the entirely odd feeling of a baby kicking on the inside while the water presses against the outside. I begin walking through the three foot section of pool. Then I get to the four foot section and begin that little water hop thing to keep my head above the water. Then the water is too deep for me to retain contact with the bottom of the pool so I take one last hop and try to propel myself into a float. And nothing happens. I sink like a rock.
"That's weird," I think to myself and try again. And once again, the muscles do not engage. I push myself backwards and try to tread water. I can't. My muscles seem to have lost all memory of buoyancy. I went swimming last summer. I could float then. Something about my distended belly and the strange sensations of the water made my body revolt against the idea of floating in water.
I quickly reassess and decide to sheepishly do the wall hanging scoot of shame where I cling to the side of the pool and scoot myself past the "deep" end. I realize I am now an old lady in need of a pool noodle floatie. I regain my footing on the other side of the dreaded deep and find myself a pool noodle to hang on since I cannot trust my own muscles to work.
We all spend most of an hour playing in the three to four foot area of the pool. Marian was thrilled with the back float she accomplished by throwing her body backwards over her ring float and thrashing her legs and arms about wildly. I helped the other children with a few other activities, but mostly I tootled around on my old lady noodle trying not to sink.
The time came to get out of the pool. I once again had to traverse the deep section. I didn't even try to float myself over it. I probably should have after spending so much time acclimating to the feeling of being underwater. I just did the wall scoot of shame going the other direction.
I arrived at the steps and slowly pulled myself out of the water. I then had one of the strangest feeling I have ever encountered in my entire life. I can only describe it as what an astronaut might experience coming back to earth. The full force of gravity came to bear on me. I could hardly move. I stood there standing, dripping at the edge of the pool trying to find the ability to walk. All of my limbs felt weighted down like lead. I slowly shuffled back across the pool, passing a table full of teenagers on the way (Hurrah!), my feet barely clearing the ground to propel me forward. It was the very definition of ridiculous to behold. Then, after a few minutes, the feeling passed and I could walk around normally. Well as normal as possible in these days of the Big Giant Belly.
So that's my swimming while pregnant experience. Should I attempt this folly again?
*Big Giant Belly is Marian's official name for my current girth.
My sister's neighborhood has a pool and she mercifully invited the entire crew to go swimming with her kids. I found a swimsuit that I could passably wear with my Big Giant Belly* and packed all the children off to the pool.
After getting everyone sunscreened and into the water, I had to figure out how to safely get myself into the pool. The kids were all playing on this side of the pool, but the stairs were on that side of the pool. I didn't trust myself to just plop myself into the water so I decided to walk over to the stairs and then walk/float back over to where all the children were.
Now this isn't an Olympic style pool or even one you might see at a rec center. This is what you might call a hotel style pool. It is a rounded off rectangle with the deepest part in the center of the long side of the rectangle. The two short sides of the rectangle are 3 feet deep that increase to four feet and then hit five entire feet of depth in the center. Since I am about 5'2'', I knew I could walk most of the way and then just float across the five foot center.
I slowly descend into the water and feel the entirely odd feeling of a baby kicking on the inside while the water presses against the outside. I begin walking through the three foot section of pool. Then I get to the four foot section and begin that little water hop thing to keep my head above the water. Then the water is too deep for me to retain contact with the bottom of the pool so I take one last hop and try to propel myself into a float. And nothing happens. I sink like a rock.
"That's weird," I think to myself and try again. And once again, the muscles do not engage. I push myself backwards and try to tread water. I can't. My muscles seem to have lost all memory of buoyancy. I went swimming last summer. I could float then. Something about my distended belly and the strange sensations of the water made my body revolt against the idea of floating in water.
I quickly reassess and decide to sheepishly do the wall hanging scoot of shame where I cling to the side of the pool and scoot myself past the "deep" end. I realize I am now an old lady in need of a pool noodle floatie. I regain my footing on the other side of the dreaded deep and find myself a pool noodle to hang on since I cannot trust my own muscles to work.
We all spend most of an hour playing in the three to four foot area of the pool. Marian was thrilled with the back float she accomplished by throwing her body backwards over her ring float and thrashing her legs and arms about wildly. I helped the other children with a few other activities, but mostly I tootled around on my old lady noodle trying not to sink.
The time came to get out of the pool. I once again had to traverse the deep section. I didn't even try to float myself over it. I probably should have after spending so much time acclimating to the feeling of being underwater. I just did the wall scoot of shame going the other direction.
I arrived at the steps and slowly pulled myself out of the water. I then had one of the strangest feeling I have ever encountered in my entire life. I can only describe it as what an astronaut might experience coming back to earth. The full force of gravity came to bear on me. I could hardly move. I stood there standing, dripping at the edge of the pool trying to find the ability to walk. All of my limbs felt weighted down like lead. I slowly shuffled back across the pool, passing a table full of teenagers on the way (Hurrah!), my feet barely clearing the ground to propel me forward. It was the very definition of ridiculous to behold. Then, after a few minutes, the feeling passed and I could walk around normally. Well as normal as possible in these days of the Big Giant Belly.
So that's my swimming while pregnant experience. Should I attempt this folly again?
*Big Giant Belly is Marian's official name for my current girth.
Friday, June 30, 2017
Catholic Fail
Last Friday, I hauled myself and all the children downtown to an ordination at the Cathedral. One of the ordinands had been assigned as a temporary deacon at our parish last summer so I thought it would be a good experience for the children. I have zero pictures of this event.
After the (very long) Mass, I gathered my crew into the social hall for the reception with food. Trying to feed four children and myself, all by myself, in a crowded room with long lines for food after they have spent the better part of three hours at Mass was an adventure all unto itself. And lo, we all survived.
After not too long, the newly ordained priests emerged and two stations were set up for them to offer their first blessings. The lines got long very quickly. Seeing as I had never had a first blessing before, even though I have been to several ordinations, I decided to take my place in line, in spite of the fact that Marian was lapping the reception room.
At last I make it to the front of the line.
The new Father then asks me, "Who's your patron saint?"
Me, "Um?"
Father, "Well then who was your confirmation saint?"
Me, "So, when I was confirmed, they discouraged us from taking saint names sooooo."
Father, "So which saint do you have a particular devotion to?"
Me, blankly, "Weeeellll?"
Assistant Guy, gamely holding the blessing book watching this little debacle unfold, "How about St. Gerard, the patron of expectant mothers?"
Me, with my giant belly that regularly wins me inquiries about twins, "That sounds like a good idea because I am definitely there."
Father, "St Gerard, it is."
"May, through the imposition of my priestly hands...."
Then I kissed his hands. I've never done that before either.
After the (very long) Mass, I gathered my crew into the social hall for the reception with food. Trying to feed four children and myself, all by myself, in a crowded room with long lines for food after they have spent the better part of three hours at Mass was an adventure all unto itself. And lo, we all survived.
After not too long, the newly ordained priests emerged and two stations were set up for them to offer their first blessings. The lines got long very quickly. Seeing as I had never had a first blessing before, even though I have been to several ordinations, I decided to take my place in line, in spite of the fact that Marian was lapping the reception room.
At last I make it to the front of the line.
The new Father then asks me, "Who's your patron saint?"
Me, "Um?"
Father, "Well then who was your confirmation saint?"
Me, "So, when I was confirmed, they discouraged us from taking saint names sooooo."
Father, "So which saint do you have a particular devotion to?"
Me, blankly, "Weeeellll?"
Assistant Guy, gamely holding the blessing book watching this little debacle unfold, "How about St. Gerard, the patron of expectant mothers?"
Me, with my giant belly that regularly wins me inquiries about twins, "That sounds like a good idea because I am definitely there."
Father, "St Gerard, it is."
"May, through the imposition of my priestly hands...."
Then I kissed his hands. I've never done that before either.
Sunday, June 25, 2017
The Gospel According to Lice
Today's Gospel was particularly apt for this week of dealing with lice.
Even all the hairs on your head are counted.Yes, children, this is true. And I have seen every one of those hairs this week.
Matthew 10:30
Wednesday, June 21, 2017
The Scourge
It has come to pass that once again the lice have come to visit our house while I am pregnant. Is this a rule? Lice while pregnant?
I did not anticipate spending my day, indulging my primate instincts, picking nit after nit out of my offsprings' hairs. The problem with lice during pregnancy is that I am not comfortable dousing myself or others in neurotoxin to kill the noxious bugs. Therefore my husband has to do the heavy lifting of washing all the children's hair in gross chemical while I pick, pick, comb, pick. And did mention the laundry?
We have yet to determine if I also have the scourge. I hope not. Since I am avoiding the neurotoxin, my lice removal protocol borders on ridiculous. Lots of oil and vinegar and plastic and time.
One bright side is that Marian relishes saying the word lice. Lice. LLLLLLice. She sticks her tongue out between her teeth. LLLLLLLLLice with a long L. She also explained we needed to put the lice eggs back in her hair so the babies would survive. Apparently there has been too much Wild Kratts around here.
I did not anticipate spending my day, indulging my primate instincts, picking nit after nit out of my offsprings' hairs. The problem with lice during pregnancy is that I am not comfortable dousing myself or others in neurotoxin to kill the noxious bugs. Therefore my husband has to do the heavy lifting of washing all the children's hair in gross chemical while I pick, pick, comb, pick. And did mention the laundry?
We have yet to determine if I also have the scourge. I hope not. Since I am avoiding the neurotoxin, my lice removal protocol borders on ridiculous. Lots of oil and vinegar and plastic and time.
One bright side is that Marian relishes saying the word lice. Lice. LLLLLLice. She sticks her tongue out between her teeth. LLLLLLLLLice with a long L. She also explained we needed to put the lice eggs back in her hair so the babies would survive. Apparently there has been too much Wild Kratts around here.
Saturday, June 17, 2017
Whence Competence?
Checking in here again. My writing muscle is quite flabby. Now that summer has arrived, hopefully I will be able to engage in the blog habit a little more regularly.
These last few months have been an exercise in endurance. Even now, we are still trying to wrap up the end of the school year and finish the never-ending math book. School was cut to the very basics and still we struggled to finish. Now summer obligations cut into our days and make the stray ends harder to gather together. Perhaps by the end of this upcoming week I can officially call the school year over.
The pregnancy is proceeding apace with everything looking healthy and normal. We are once again expecting another girl. The symmetry of two girls, a boy, and two more girls is pleasing. Sam is going to be well-prepared for adulthood. Heh.
Even though everything pregnancy-wise seems healthy, my own perseverance has not been very valiant. Although I embraced all the meds this time, the nausea just kept hanging on. I am still taking something every night before bed because my schedule has been such that finding out I am still nauseous in the morning would not be amenable. Not the most terrible, but not great either. Maybe after school is put away, I'll try to wean off the nausea med again. Again, again. Heartburn is a daily part of my life. Constant choking burning heartburn. My ability to ignore these feelings and carry on is not my strong point. I have been sleeping 10-11 hours a night, plus plenty of rest throughout the day. Mild anemia is doing its work, taking my energy and raising my heart rate.The second trimester energy boost never quite arrived and now the third trimester promises to be more (or less) of the same.
As a result, the household is running on fumes and threads. I haven't cooked in months. The housekeeping is sad. The children have been cleaning the kitchen, but it's about as clean as you'd expect when children clean a kitchen. And the whole household project left over from last year's disastrous summer still looms over my head.
I have been home from work for close to two years. I wonder when I will feel competent in any of this. It seems like as soon as I begin to feel like I am gaining control over any particular situation, the stool gets kicked out from under me and I have to begin again. I do not feel quite as unmoored as I did in the beginning, but it definitely feels like a three steps forward, two steps back situation. I feel like if I could just...fill in the blank...and then everything would work itself out. This probably isn't reality. It works itself out, one way or the other, no matter my competence or energy.
I know that other people have moved and cooked and been pregnant and had babies and done all the things I have been doing and probably felt like they muddled through just like I do. It's possible to do these things. I just wonder when it starts feeling doable instead of impossible.
These last few months have been an exercise in endurance. Even now, we are still trying to wrap up the end of the school year and finish the never-ending math book. School was cut to the very basics and still we struggled to finish. Now summer obligations cut into our days and make the stray ends harder to gather together. Perhaps by the end of this upcoming week I can officially call the school year over.
The pregnancy is proceeding apace with everything looking healthy and normal. We are once again expecting another girl. The symmetry of two girls, a boy, and two more girls is pleasing. Sam is going to be well-prepared for adulthood. Heh.
Even though everything pregnancy-wise seems healthy, my own perseverance has not been very valiant. Although I embraced all the meds this time, the nausea just kept hanging on. I am still taking something every night before bed because my schedule has been such that finding out I am still nauseous in the morning would not be amenable. Not the most terrible, but not great either. Maybe after school is put away, I'll try to wean off the nausea med again. Again, again. Heartburn is a daily part of my life. Constant choking burning heartburn. My ability to ignore these feelings and carry on is not my strong point. I have been sleeping 10-11 hours a night, plus plenty of rest throughout the day. Mild anemia is doing its work, taking my energy and raising my heart rate.The second trimester energy boost never quite arrived and now the third trimester promises to be more (or less) of the same.
As a result, the household is running on fumes and threads. I haven't cooked in months. The housekeeping is sad. The children have been cleaning the kitchen, but it's about as clean as you'd expect when children clean a kitchen. And the whole household project left over from last year's disastrous summer still looms over my head.
I have been home from work for close to two years. I wonder when I will feel competent in any of this. It seems like as soon as I begin to feel like I am gaining control over any particular situation, the stool gets kicked out from under me and I have to begin again. I do not feel quite as unmoored as I did in the beginning, but it definitely feels like a three steps forward, two steps back situation. I feel like if I could just...fill in the blank...and then everything would work itself out. This probably isn't reality. It works itself out, one way or the other, no matter my competence or energy.
I know that other people have moved and cooked and been pregnant and had babies and done all the things I have been doing and probably felt like they muddled through just like I do. It's possible to do these things. I just wonder when it starts feeling doable instead of impossible.
Saturday, April 1, 2017
What Was I Saying Again?
I was supposed to be talking about our lunch routines and complaining about the crockpot, but the truth is those posts were probably the last time I made or served lunch. We quickly descended into a feral survival mode when an old, familiar malady came to visit me.
Yes, I am once again growing a person.
When I am newly pregnant, I always make absurd promises to myself like I will continue exercising every day even if I don't feel well or make a goal of more frequent posting. You'd think I'd know better by now. The resolve doesn't last long. Soon I take my post on the couch and wait for the awfulness to end.
MrsDarwin valiantly continued posting through her dark days:
One of the great wonderings of my life was did I have such hard experiences with pregnancy because of working and commuting and generally pushing myself too hard when I should be resting. The answer is a resounding NO! This time has been exactly as bad as the others. Hurray. I found myself, in the depths of the worst of it, wondering how I went to work through all this? I know I did it. I did it four times, but I'm not sure how anymore. The only significant difference this time was that I felt myself begin coming out of the ditch at about 12.5 weeks rather than the normal 14. This "early" start to the reprieve only led me to fear miscarriage because, obviously, the books that say you should start to feel better around 12 weeks have lied through four previous pregnancies.
I am now 16 weeks and the worst is over. I am not 100%, but I am also not permanently planted on the couch anymore. My goals now are to slowly regain my endurance because, wow, atrophy is a thing, and to find order in the house again because three months is a long time to ignore it all. (My husband will be thrilled when I feel well enough to cook supper. Almost but not yet.)
NB: I thought about posting this yesterday, but I decided against it because it might be confusing.
Yes, I am once again growing a person.
When I am newly pregnant, I always make absurd promises to myself like I will continue exercising every day even if I don't feel well or make a goal of more frequent posting. You'd think I'd know better by now. The resolve doesn't last long. Soon I take my post on the couch and wait for the awfulness to end.
MrsDarwin valiantly continued posting through her dark days:
If you told me when I had my first that I would do this six more times (seven, counting the miscarriage, but I was never sick then), I would have turned my face to the wall and died.And that about says it all. This is only my fifth time (Only five. Ha! I think I need a medal.), but the sentiment holds. It is somewhat unbelievable I am living through this again. Pregnancy, especially the first half, is a time of muttering perseverance for me. Everything grinds to a halt. No shopping, no food prep. I cannot concentrate and can barely speak as the inevitable happens over and over again. Our homeschool is a shadow of its former self. The cleaning and laundry are all on emergency basis only. My step counter shows months of woe. The only items on my agenda are sleeping and carefully eating food that someone else prepared and put in front of me.
One of the great wonderings of my life was did I have such hard experiences with pregnancy because of working and commuting and generally pushing myself too hard when I should be resting. The answer is a resounding NO! This time has been exactly as bad as the others. Hurray. I found myself, in the depths of the worst of it, wondering how I went to work through all this? I know I did it. I did it four times, but I'm not sure how anymore. The only significant difference this time was that I felt myself begin coming out of the ditch at about 12.5 weeks rather than the normal 14. This "early" start to the reprieve only led me to fear miscarriage because, obviously, the books that say you should start to feel better around 12 weeks have lied through four previous pregnancies.
I am now 16 weeks and the worst is over. I am not 100%, but I am also not permanently planted on the couch anymore. My goals now are to slowly regain my endurance because, wow, atrophy is a thing, and to find order in the house again because three months is a long time to ignore it all. (My husband will be thrilled when I feel well enough to cook supper. Almost but not yet.)
NB: I thought about posting this yesterday, but I decided against it because it might be confusing.
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