Dr. Maestro

When I first started seeing a gyno, I was certain I wanted a woman. I felt that I would be more comfortable seeing a woman. Since I was still a teenager (gasp!), I chose to see the wonderful nurse practitioners (CRNPs) at Family Planning. I went there for years for my care, so many years that they used to joke about the thickness of my file and ask when I was going to start seeing a "real" doctor, as by that point I was in my thirties and had a job and insurance and all the things that usually made people jump ship. I told them that I would probably switch when I needed an OB. Although they had an OB on staff and could do prenatal care, their office was far enough away from where I now live (back in my hometown), that I wouldn't want to make the long drive as often as one does for prenatal visits (once a year for my annual I didn't mind) and I'd want to deliver closer to where I live. But since that wasn't an issue yet, year after year I kept going to see the CRNPs.

Then their office building burned to the ground.

I took it as a sign from the universe that it was time to grow up and find a "real" doctor. (I also took it as a sign from the universe that I was a virgin again, since every gynecological record that ever existed about me was destroyed in the blaze.) I asked around for referrals from my friends, and OldChristine practically begged me to start seeing her gyno. He was wonderful, she said. In fact, she couldn't praise him enough. But I still thought I'd be more comfortable with a woman doctor.

So I asked my friends who are doctors themselves who they would recommend (since these friends are also women themselves). They recommended a woman they had gone to medical school with, who was our age, and who I was able to meet socially first to see if we clicked before making an appointment. This was the doctor that started treating me for infertility. We went through a few cycles of testing and early treatment and she directed me to call to schedule an HSG if my next cycle failed. Which it did.

So I called her office (a group practice) on cycle day one and was told she had quit the practice and moved to Hawaii.

I was practically in tears (okay, I was in tears), trying to explain to the nurse that I was supposed to schedule a test, that I didn't want to lose a cycle, but that I didn't think they had another woman doctor on staff. I offered to call back when I was more collected, but the very sweet nurse would not let me off the phone until she helped me. She scheduled an HSG with a woman doctor at a nearby practice with whom they were affiliated. This new doctor was fantastic. She did my HSG (without having even met me first), immediately scheduled me to come in to her office to discuss further treatment, and best of all, she prescribed the Clomid regimen that got me pregnant with the Monkey.

When I called her office to report I was pregnant and schedule my first prenatal visit, they told me "Congratulations! But this office won't be doing deliveries anymore in a few months, so although we can start your prenatal care, you'll need to find a new OB."

At this point, I was starting to think I was cursed. In near desperation, I called OldChristine and asked for the name of her OB, the man she worshiped for his reported god-like gynecological and obstetric abilities. He'd been in solo practice in the same location for years. When I asked OldChristine what would happen if he was, say, on vacation, when I went into labor, she replied, "He doesn't take vacations. He will be there for your birth. Wait until you meet him. He loves what he does and lives for his job."

I scheduled my first prenatal appointment, but when I got to his office he had been called away to deliver a baby, so I had my introductory pelvic done by his PA. I met him at my next prenatal visit, but he never saw me with my pants off until the birth. The god-like abilities so praised by OldChristine? All true.

I've finally christened my OB with the pseudonym Dr. Maestro. I believe that the birth of the Monkeyboy went easily because of his skill (part of the credit also must go to my uterus, though). The HSG he did last fall was a dramatically less painful -- actually, not painful at all -- experience than my first was. And, I must add, the most impressive feat of all was that ten years ago, he delivered OldChristine's twins vaginally. (You hardly hear of such a thing anymore). When dealing with other medical professionals, he's got a touch of the diva in him (which can be seen in the final installment of the Monkeyboy's birth story), but with patients he's understanding. He's got years of experience, but a forward-thinking mind. And he's been gifted with the hands of a master.

* * * * * * * * * *

Yesterday, Dr. Maestro walked in the exam room, opened with "So, we're having a big baby, aren't we?" and chuckled.

Not what you want to hear from your doctor.

Dr. Maestro has always been good at quelling my fears and not letting my mind run away with worst-case scenarios. He's got a skeptical mind and presents things very straight-forwardly. I was hoping he would pooh-pooh the ultrasound as being only somewhat accurate in its estimation of the baby's size, but instead he seemed to put a reasonable amount of faith in it. Part of the belief is based on the fact that the Monkeyboy was big for his gestational age, so logically it follows that this baby could be slightly bigger. Which it is.

When he measured my fundal height, he said I was measuring at 35 weeks, which isn't as far behind as the PA thought. I told him I was worried about the baby's size, but he said, "Maybe when I'll check you you'll be four centimeters and we won't need to worry." I told him I doubted it. What he found? No surprise. Long, closed, firm and posterior. The only positive is that the baby has finally dropped a tiny bit: to a -1 station. I'll take what I can get at this point.

We discussed the big baby scenario and discussed my pelvic size. I reminded him of the "small pelvis" comment he made during the Monkeyboy's birth; since he'd just finished doing my pelvic, he nodded and said, "True."

"Let's hope you go into labor on your own soon," he said. "How does 37 1/2 weeks sound?" I told him it sounded great to me, but that based on my lack of progress, it didn't sound like that was going to happen. And if it didn't, did we have a plan? "Because I'd really like to not end up with stuck shoulders or some other complication."

"I don't want stuck shoulders .... they're no fun for the doctor either," he said.* "What I'd like to do is induce you at 38 weeks, if you're inducible."

I can't believe how quick I jumped at this option. My response? "I'm very open to that idea, if I'm inducible."

For those of you playing along on Bishop's Score: The Home Game, I'm not inducible. Even adding a point for having a previous vaginal birth only nets me a 3. The fourteen days to 38 weeks seems so long, and yet, so short when I think of how I've shown no progress so far. So many second-time moms are walking around 50% effaced and a few centimeters dilated at this point. Me? The girl who had such a hard time keeping a baby in last time? Showing no progress. However, I know that nine days before breaking my water with the Monkey, I was long, closed, firm and posterior. Even three hours after my water broke, I was still only one centimeter, yet I made it to ten centimeters dilated in the next five hours. I didn't think to ask the doc what he personally means as "inducible." That will have to wait until my next appointment, when I'm sure it will come up again. Until then, I'm thinking "open" thoughts. I'll even take one centimeter. Please.

As he left, he made the usual comments about calling the office if I have any regular contractions or any leakage of fluid before my next appointment, to which I responded, "I wish."

Other stats: Weight up a pound at 155 1/4 (30 1/4 gain total); blood pressure an awesome 122/58; baby's heartrate 148; Strep B test negative.


*Although I'm thinking that they're really a whole lot less fun for the mother and baby. And while we're at it, I'd like to say, what's up with the "We're having a big baby" comment? Only one of us has a uterus.

36 Weeks

Last fall, when I found out I was pregnant, there was a lot of speculation among friends and family members about all the unknowns. Would I deliver early again? Would it be a girl or a boy? When asked what I thought, I once said, "Oh, I don't know, but a small, six pound girl born at exactly 36 weeks with no NICU time would be nice."

Two months into this pregnancy, my friend Heather gave birth to a small, six pound girl at exactly 36 weeks with no NICU time. I knew then that for me it would be a completely different story.

It's hard to believe that in just a couple of months time, I've gone from obsessively wanting to keep this baby in to now wanting this baby to come out (well, soon, at least). I RSVP'd to a birthday party yesterday for June 7, thinking that hopefully, by then, this baby will be here. I'm going to state right now for the record, if I go into June, I'm going to be pissed. If I go to 42 weeks (June 11), this will be a pregnancy that was two months longer than my previous one.

Weights and Measures

Well, apparently I do have that much room in me for a baby. And measuring at 32 weeks means nothing.

The ultrasound went well, although I knew it wouldn't be very exciting. When the PA had said to me on Wednesday, "At least you'll get another look at the baby!" My thought was, "Well, not really..." I'd had an ultrasound at around 28 weeks with the Monkeyboy and I remembered how crowded he'd been then. I couldn't even begin to imagine how cramped and pretzel-like this baby must be at 35 weeks.

Uh, pretty damn cramped and pretzel-like.

The ultrasound tech was very nice, one we'd had before. Although I could see the ultrasound screen they have angled for the parents to view, I couldn't read the measurements at the bottom. I saw the Hubster shift in his seat so that he could read them, so I knew he'd tell me later. (I almost wish he hadn't.)

After taking her time with all the usual measurements, including checking the amniotic fluid level, the tech spent a long time trying to get us a good 3-D (4-D?) ultrasound picture. I've always thought they were kind of creepy, but I guess when it's your baby, it's a little cooler. Kind of creepy-cool. But it still kind of looks like a generic baby, all smooshed up.
The baby kept his hand in front of his face almost the whole time (I'm sure due to the general smooshed-ness), but the tech was very persistent and even had me change positions a couple of times to try to get a good face shot. (I think she felt badly that we hadn't been able to get a video last time because they didn't tell us that they'd switched to DVD. I noticed that now in the waiting room, they have a sign that says you can buy a DVD or CD.)

After all if this, the tech left to make some calculations. When she returned, here's what she laid on us: The amniotic fluid level looks fine. The baby looks just fine and based on the measurements they took, they can estimate the baby's size at this time. The baby is not measuring small for dates like the PA worried.

Now, just for fun, let's peruse a few selections of Your Pregnancy, Week by Week (Remember, I'm at 35 weeks):

Week 35 "Your baby now weighs over 5 1/2 pounds." Uh, no. But that's about what the Monkeyboy weighed at 34 weeks.
Week 36 "By this week, your baby weighs about 6 pounds." Keep guessing.
Week 37 "Your baby weighs almost 6 1/2 pounds." Getting warmer...
Week 38 "At this time, your baby weighs about 6 3/4 pounds." Ding ding ding ding! We have a winner!

Right now they estimate the baby weighs about 6 pounds, 12 ounces. At 35 weeks 2 days. Now, I know that ultrasound estimates of the baby's weight are notoriously inaccurate, but it's hard not to get wrapped up in the numbers.

She said, "If you go to full term, we think the baby will weigh about 9 pounds, 1 ounce."

Part of me is hardly shocked by this. When I was pregnant with the Monkey, I kept saying "If he goes to full term, I expect he'll be at least an 8 pound baby." My mother-in-law once asked me why I thought this, as the Hubster wasn't that big at birth. "What did he weigh?" I asked her, although I knew the answer. "7 pounds, 15 ounces," She answered. "You do realize that one more ounce would be eight pounds, right?" I asked.

Research about pre-term infants suggests that by their due date, they have caught up to what their birth weight should have been. By his due date, the Monkeyboy was 8 pounds 3 ounces. I myself had weighed 7 pounds, eleven ounces 35 years before when I was born (although I'm a short little thing now). Babies are just getting bigger these days, for a variety of reasons (like more nutritious foods and moms who don't smoke through pregnancy or try to keep their weight gain to the recommended twelve pounds that was told to OldChristine's mother back in 1970).

Now, I know that ultrasound estimates of fetal weight are notoriously inaccurate, with a margin for error reported, in the past, as being as high as 15-18%. However, they're getting better. My research shows that while these estimates are somewhat unreliable when done after 37 weeks gestation (birth weights currently reported as within 11% of estimates), they're considerably more reliable when done between 34 and 37 weeks (birth weights closer to within 6.2% or less of estimate). Much of the reason for ultrasounds being unable to reliably predict fetal weight after 37 weeks is that often by then, the baby's head is engaged low enough in the pelvis that an accurate measurement can't be made. So I guess there's something to be said for the -2 station he's been riding at, after all. The Hubster reported that when the ultrasound tech was determining the head circumference, the measurement came back as 37 weeks 4 days.

How is it that my fundal height suggests 32 weeks, but the ultrasound suggests a fetal weight of 37-38 weeks? I'm only 5'2"! Where the hell is this baby finding the room? Is my uterus a biological tardis, with more room on the interior than the exterior? Or is this an indication that in my case, the ultrasound is inaccurate and I'm just having an average baby?

Nobody is more aware of the truly ironic dichotomy presented by two of my biggest birth fears. First, that I would pPROM again and this baby would be born even earlier than the Monkeyboy. That obviously didn't happen. Now I can replace that with the newfear, first foreshadowed by my 18-week level II ultrasound back in December, that this will be the Incred.ible H.ulk Baby.

When I raised this concern months ago with my OB (and reminded him that he commented on my small pelvis size during my first birth), he said we'd revisit the subject again if it became an issue. By the time I see him again on Wednesday, I'll be 36 weeks and the baby, if the ultrasound is even reasonably close to accurate, will be about seven pounds (estimates usually add at least an ounce a day). I think the time has come to revisit this subject. (Fears: cephalo-pelvic disproportion, c-section due to macrosomia, shoulder dystocia, second-, third-, or fourth- degree episiotomy, among others).

I don't know that there are any good answers to my questions or solutions to my concerns, but I'd like to start thinking up strategy. What I'd love is for this baby to decide to come on his own sometime within the next couple of weeks. I'd be open to discussing an induction after that point, after about 38 weeks, if my Bishop's Score improves, but not before there's some progress. My biggest fear is that I'll just go to term with no plan, a possibly too big baby (for me) and the big sword of "what if" hanging over my head.

Wednesday Afternoon Slap and Tickle

We interrupt the regularly scheduled programming for a current news update. Conclusion of Monkeyboy's birth story will come soon, I promise.

Yesterday was my weekly appointment (35 weeks), which for the last several weeks has gone past the usual wee n' weigh to include a check under the hood. As I told the Hubster the other day, "I'm getting more action from my doctor than I am from you these days." In the matter of good news/bad news, the good news is: I'm not progressing; the bad news is: I'm not progressing (I don't want to be pregnant forever, okay?)

Progress is usually calculated using the Bishop Score, which is comprised of five components: cervical dilation, effacement, consistency, position and the baby's station. Although the PA threw me a bone by saying the baby is at a -2 station (moving him ever so slightly south from the -3 where he's been), everything else on that list was a big negative. My cervix is still long, firm, closed and posterior (so for effacement, consistency, dilation and position, that's a big no, no, no, and no progress). The good news is that, for now, this baby isn't going anywhere. The bad news is that, well, is he ever going anywhere?

The baby's heart rate was around 142. My weight is at 154 1/4 which is a two pound weight gain since last week (but averages only to a pound a week since I hadn't gained any last week. It's only a 29 1/4 weight gain overall, so that puts me at where I was nine days before the Monkey was born (I only weigh myself at the doctor's office). My blood pressure was somewhat elevated (for me, that is), at 138/60 (I'm usually about 110/60 max), but there's no protein in my urine and I have no swelling going on, although, apparently swelling isn't considered to be the significant factor it once was when diagnosing pre-eclampsia. And of course, HELLP syndrome is high on my list of things I like to obsess about during this pregnancy, so it's always nice to have another, related concern along for the ride (especially because I've had low grade headaches, slight nausea, and pain under my right-hand ribs for the last few weeks -- all of which I forgot to ask the PA about).

The baby is still head down, and the PA commented (for the third time now) that it was a very clear exam. She had a student with her and asked if the student could palpate my uterus to see what it felt like, because it was so obvious. They played around for a few minutes, feeling for body parts. It was interesting hearing them talk about it, because it confirmed what I've been thinking I could feel when I do the same thing to myself. The PA (really wish I could come up with a cool pseudonym for her) told the student that it was not always as easy to tell on some women and commented that my exam was so clear because I'm so petite and really "all baby." This is a double-edge sword, as we will see in the next paragraph.

The most significant factor right now -- and there's always something, isn't there? -- is that I'm measuring 32 weeks at 35 weeks. For the last month or so, pretty much since I started my weekly appointments, I've been measuring a little behind where I should. At first, it was only by a week, which really means nothing, but then it was by a couple of weeks and now by three weeks, so tomorrow I'm going for another ultrasound. The PA said she wanted to make sure that I didn't have low amniotic fluid and that the baby was measuring appropriate for the date. She also said not to worry, that the small measurement could be due to the fact that, as she had said before, I am very petite and "all baby." I'm trying not to worry, but my mind goes in all sorts of unpleasant directions. I'm not the only one. After I called the Hubster to tell him I was scheduling the ultrasound, he texted me "What is she concerned about? IUGR?" ( We have a friend whose first baby was an eight-plus-pounder, but then had two IUGR babies.) I've said it before: In pregnancy, anything's possible.

As I mentioned the other day, I've never been this pregnant before, so it's hard to know what to expect at this point. Is it possible that I just don't have that much room in me for a baby? I remember reading on a message board a comment by a women who had had three pre-term babies. She said they had all been born healthy and with developed lungs, even as early as 32 weeks. She said her doctor suggested that since she was petite, it was like her body got the babies ready and just said, "Five pounds and... you're out!"

I also had the Group B Strep test done, which, if the past is any predictor of the future, will end up being some further complication I have to deal with. (Sorry for that dive back into the Sea of Pessimism.)

Edited to Add: All afternoon I felt pretty crappy, had a headache and just felt terrible. The more I thought about my blood pressure at yesterday's appointment, the more it bothered me, so I stopped at the drugstore and took my BP this afternoon, which registered at a reassuring 118/65.

Uncharted Territory (or the Monkeyboy's Birth Story, Part 2)

I have never been this pregnant before (and I can say that every day until this baby is born). With the Monkeyboy, at what would have been 34 weeks 6 days, I was holding him in my arms in the rocking chair in the NICU. While I try not to dwell on the increasing discomfort that the next, possibly-five weeks are sure to bring (remember, I'm still in denial about the possibility of going overdue this time), I'll try to finish the Monkeyboy's birth story.

* * * * * * * * * *

Part 2...

I continued to leak amniotic fluid as I cleaned up the puddle I'd made on the bathroom floor, and called the Hubster. "Where are you?" I asked.

"I'm on my way home for lunch," he replied. It was about 11:30 a.m. on Saturday.

"Good, because I think my water just broke. I'm going to call the doctor. See you when you get here."

I called the answering service and waited for the doctor to call me back. After asking me a few questions (he was probably trying to make sure I hadn't just peed myself), my OB told me I should head in to the hospital (it's an hour long drive for us) and, if they determined that my water had broken, he'd be in to see me.

I got dressed and finished throwing together my hospital bag. I was very glad that I had struggled through my shopping trip of the night before. The one thing that I was lacking were comfy socks to deliver in, but nothing could be done about that (although I did briefly consider stopping at Wa.lm.art on the way to the hospital).

When the Hubster got home, he packed a bag for himself, too. "So if the hospital determines that your water has broken, what then?" He asked.

"They'll deliver the baby."

Oddly, I was not scared by what was going on. What a difference nine days make. It was simply the magical number "34 weeks" that gave me peace of mind. My friend, OldChristine, had eight-year-old twin sons that had been delivered by the same OB at 34 weeks. I knew that they had been fine and had required a NICU stay of less than two weeks. That single bit of information kept me from feeling anxious. Also, I knew that if my water had broken and labor started, at 34 weeks the hospital would not try to stop it, so, in effect, that train had left the station. All we could do was ride it out.

We threw our bags in the car, and at the last minute, I grabbed all of the baby name books and tossed them in, too. We had been going 'round and 'round about baby names since we found out the sex. Finally, a few months before, we had decided to table the discussion until the beginning of November, six weeks before the baby would be born. At this point we were each to have a list of five to ten serious contenders, which I was confident we could narrow down before the baby was born. I had been sick since the beginning of October and had not made my list yet (although we were five days into November, already). The Hubster took a piece of paper out of his wallet and waved it at me.

"I guess I get to name the baby, after all." He said, teasing.

As we got in the car, I used my cell phone to call OldChristine. She was shopping with her hubby (one of the Hubster's best friends) and sons, who were all excited when I told them what was going on. I told her I'd call her when we got to the hospital and knew what was happening. Other than the Hubster calling work to let them know he wouldn't be back, this was the only phone call we made. Until we knew what was going to happen, I didn't want to start calling family. I'm the opposite of a drama queen, more of a private, Greta Garbo-"I want to be let alone"-type. The last thing I wanted was anyone showing up at the hospital. OldChristine had expressed a desire to be there, and she was the absolute single person other than the Hubster that I was willing to have in the delivery room (other than the obvious necessary medical personnel).

By the time we made it to the hospital (after driving through a Wen.dy's on the way, because I knew the hospital wouldn't let me eat once I got there), registered and were placed in a triage room, it was about 2:30 p.m. I had soaked through the giant pad I'd put on to contain the amniotic fluid. There was a big wet spot on the butt of my jeans. The nurses and resident that saw me asked if I was sure of my gestation (I put that to bed pretty quickly with a discussion of fertility meds), asked my plans for pain relief ("An epidural," I told them. "Well, probably crying, and then an epidural."), and checked to see if my water had really broken. The resident said they use three tests to check for amniotic fluid, to make sure that at least two agree. I know they tested with a nitrazine strip and did a slide to check for ferning, but I can't remember what the third test was. I do know that the tests (like four out of five dentists quizzed on Trident gum) agreed -- my water had broken.

At this point, I'd been having only some low back pain, nothing I could label as contractions. Instead, it was more like menstrual cramps. Before doing a cervical check, the resident asked me if I'd had any leaking prior to that day. As I thought about it, I realized that I probably had been leaking since Wednesday or Thursday of that week. I remembered how at work, by the end of the day, I'd felt "sweaty," and that because of that I'd changed my pantiliner before leaving work. The more I thought about it, it occurred to me that it was a "wet" feeling, not like anything I'd had before. I told this to the resident and then added, "I probably should also mention that last night I took a bath."

The resident did a cervical check around 3:00 p.m. and declared me to be "maybe one centimeter." She tested me for Strep B, since it hadn't been done yet, and the test came back as inconclusive. So for that reason, as well as the bath issue, she decided to put in an IV , so she could start me on antibiotics. I've always been complimented by phlebotomists on my large, cooperative veins (comments like, "You must work out"), but the person they sent in to put in my hep lock took several, painful tries before she asked for help. The nurse hooked me up to a contraction monitor and a fetal heart rate monitor. Then the resident said she was going to call my doctor and she'd be back to check on me. It was more than two hours before we saw her again.

Around 3:30, a nurse came in to check on me. She said," Umm, your sister's here?" I was starting to get uncomfortable, so I apparently wasn't very patient or nice to her. I hardly remember the conversation, but the Hubster told me about it later. His actual words were, "and then you were mean to that nurse."

When she told me my "sister" was here, evidently my response was a curt, "That's impossible." (In retrospect, I'm sure it made sense. After all, we still hadn't called our families yet.) The nurse persevered. "A woman... about your age... long dark hair... she has two boys with her?"

"That's OldChristine." I snarled. "She's insane."

Since only one support person is allowed in triage (the rooms are very small) -- and I was starting to act just a little like Regan from The Exorcist -- the Hubster generously offered to step out so OldChristine could come in. He also said he was going to call our families.

"Be sure to tell them not to even think about coming to the hospital, that we'll call them when we want them here." I ordered, as he fled from the room.

OldChristine came back, very excited to be there. She said they had been shopping nearby and, since they hadn't heard anything, they stopped to see what was going on. I told her we were waiting for the doc to show up , but that they said they would probably move me to labor and delivery soon. OldChristine and her husband were going to drive home to drop the boys at her mother's and were going to come back to the hospital. "Stop at Wa.lmar.t and bring me some comfy socks," I told her, before she left and the Hubster returned.

In the meantime, the Hubster's phone began to ring. And receive text messages. (I had turned my phone off when we got to the hospital). When he'd called work to tell them he wouldn't be back, he had told them that my water had broken (I didn't know that's what he said up to this point). Through an odd set of circumstances, the wife of one of his coworkers (who wasn't even working that day!) had found out. She was also the friend that I'd talked to that morning just before my water broke. She was also the biggest gossip in our group of friends, coworkers and acquaintances. She was digging for information as to what was going on, because she wanted to be the first to know, so she could spread the word. I just wanted to be left alone. We just called our parents, for Pete's sake. When she didn't get any response from us, she proceeded to call or text every other person that we both knew in common and ask them if they had any information. This is how all of our friends found out I was in labor.

By now, I was definitely feeling something. A painful something. An unending, unrelenting, painful something. Although the Hubster and I tried to interpret what we saw on the monitor, we couldn't tell when one contraction stopped and when another one started. Apparently, this is because once contractions started they came one on top of another, with almost no rest in between. I didn't even have time to catch my breath.

Since we hadn't seen the resident in over an hour, I hadn't seen a nurse since the one I was mean to had brought OldChristine back, and my doctor had yet failed to arrive, I told the Hubster that he needed to go find someone and tell them I needed something for pain. He returned from his mission to say that he had told someone at the nurses station.

And yet, no one came to check on me.

After another half an hour -- which felt like one long, body-tensing contraction -- I sent him back out to the nurse's station. He returned again, saying this time that he had found the nurses and the resident (Remember her? The one who said she'd be back to check on me two hours ago?) watching TV. He said he was less than nice to them, and that they were right behind him. It was now about 5:30 p.m.

When they walked in the room, I was doing my best to bear the pain. I was straddling the bed and leaning forward to try to alleviate the tautness of my body, to get some relief. My entire body felt tense, from shoulders to hips. I still was unable to tell when contractions began or ended; it was just constant pain. I had tears running down my face.

"Oh, honey," the nurse said. "You said you were going to cry, but I thought you were only joking!" Suddenly, the resident was all business. She checked me again and said I was a little over three centimeters. She and the nurse started to make arrangements to move me to an L & D room, so I could get the epidural I wanted.

To be continued...

34 Weeks 5 Days (or the Monkeyboy's Birth Story, Part 1)

This was the point during my pregnancy with the Monkeyboy where he was born. I thought I'd commemorate this pregnancy milestone by finally writing the story of his birth (two and a half years later).

* * * * * * * * * *

The story really begins nine days earlier (at 33 weeks 3 days, for those of you playing along on the home game), when I arrived at work on a Thursday morning and stopped in the faculty restroom for my pre-homeroom pee break to discover that I was spotting. Since I hadn't seen blood in, oh... 33 weeks 3 days, I panicked and immediately called my doctor's office. They said it was probably nothing to worry about, but to come in anyway just to be sure (I had been there only two days prior for a routine wee n' weigh check). I started to cry a little when I told my principal I had to leave, because I was scared. It was only the end of October -- and I wasn't due until the middle of December. My due date seemed like a long way off. The Hubster met me and we drove in to the office. On the way to the office, I had my first couple of real contractions (actually, I never noticed Braxton Hicks contractions during that pregnancy at all), but it was only one or two. When I returned to work, I told a pregnant friend there (another first-timer) that I had a couple of real contractions and, "For the record... Ouch!"

At my OB's office, I was seen by the PA and her intern. They did a pelvic, declared my cervix to be long and closed (I swear I remember her saying "high and tight" because it made me think of a Marine's haircut), but discovered that I had a BV infection and a yeast infection. Lucky me; two for the price of one. For good measure, they also did a non-stress test, which found the baby doing just fine. I was sent home with a couple of prescriptions and the usual admonition not to engage in "relations," including those of the oral variety. The next morning I was still spotting a little, so I took another day off work. Since it was Friday, one more day gave me three days to rest before returning to work the next week.

By Monday I felt just fine (well, as fine as I could at that point in my pregnancy), so I was back at work. I had a new fire lit under me with the recent scare, so I frantically tried to finish getting ready for my long-term substitute. I was also trying to get my labor/hospital bag ready at home. By the end of the week, I was tired and felt terrible. In fact, I felt so terrible by the end of the day Friday that during my the last class I had another teacher watch my students for a few minutes so I could run (okay, waddle) to the nurse's office.

"Do you have a BP cuff?" I asked her when I walked in. She laughed.

"Usually teachers come in to ask me if I have a bandaid. What's wrong?" I told her I just didn't feel right, so I wanted her to check my blood pressure. She checked it, and said for good measure she'd take my temperature, too, but eventually declared everything to be normal.

"I guess I just feel like crap because I just feel like crap," I commented after I thanked her. I returned to my class and finished out the day. But I just still felt "off." It was nothing I could describe -- I just felt miserable.

It was the Hubster's last weekend scheduled to work "before the baby comes," which meant he was working that Friday night. Although I was tired and felt miserable, I still went shopping to finish getting what I needed "before the baby comes." I remember complaining on my cell to the Hubster as I drove to Ta.rget. He suggested that if I felt that bad I should just stay home, but I told him I just wanted to finish my preparations -- things like getting a nursing bra -- so that I could maybe relax a little.

My shopping seemed to take forever. They were either out of what I needed (like comfy socks for delivery) or the choices were completely new to me (I had never bought a nursing bra before). I was also not operating at peak performance due to the way I was feeling. I think I spent about fifteen minutes standing in front of the maxipad selection alone, trying to determine what I needed for postpartum (since I hadn't used them since junior high). On the drive home after my marathon shopping trip, I was so tired, felt so strange, and yet was still being plagued by my usual late-pregnancy complaints (like tingly, painful hands that fell asleep as I drove), that I cried. In retrospect, driving along, alone in the dark, crying, was not a good sign. At the time, though, I didn't see it as a foreshadowing.

At home, I soaked in a bath because it sometimes reduced the swelling in my feet and calves and calmed the restless leg syndrome to help me sleep. Then I went to bed, determined to sleep in the next day. I also had plans to do laundry and clean my house. These needs had built to embarrassing proportions because I had been so sick for the last month, I could do nothing but lie around and try to feel better.

Saturday morning, I chatted with a friend of mine on the phone (she had just had her baby nine days previously, the day I had started spotting). She asked what I had planned for the day, since the Hubster was working, and I said, "I'm going to go to the grocery store, then come back, do laundry and clean my house."

I got dressed and, before I left the house, decided to check something in one of my pregnancy and birth books. As I bent over to get the book from a low shelf, I sneezed and felt a small gush of fluid. Did I just pee myself? I wondered. I had just gone to the bathroom, but knew that in late pregnancy, just about anything's possible. So, back to the bathroom I went, to be absolutely sure this time that I emptied by bladder. As my little "accident" had overflowed my pantiliner, I changed my clothes from the skin out. Then, while washing my hands, I felt another small gush of fluid. What the hell?! I thought, although it was starting to dawn on me what was probably happening. Remembering that the Girlfriend's Guide to Pregnancy said if at all possible, take a shower as soon as labor starts, since you don't know how much longer it will be until you get another one, I decided to take a shower before I went to the grocery store, just in case. I undressed, and as I crossed the bathroom to the shower, the floodgates opened. This was no small gush. It was absolutely, undeniably, obvious to me that my water had just broken.

To be continued...

No credit for time served

Julie over at A Little Pregnant came up with this concept, refuting the idea that if you've suffered with infertility, your subsequent pregnancy and birth should be smooth sailing. And although my first pregnancy wasn't as tough as some women's, and eventually had a good outcome, it wasn't exactly a dream cruise, either.

This time around, I've been expecting all along to be hit by not only my old battery of symptoms and side effects, but a whole new barrage of uncomfortable experiences. And at 34 weeks 4 days, I'm still waiting.

Sure, I've had a mild recurrence of restless leg syndrome, but it's been very sporadic and hardly worth mentioning. And some days my hands seem a little puffy and stiff, but I've avoided the carpal tunnel and ulnar neuropathy that made my upper extremities numb, useless stumps last time. The only real condition of concern is my anemia. At this point, my hemoglobin is up to 10.6, so it has been creeping upward, just incredibly slowly. And the most recent bloodwork I had done was not reassuring to the PA, who at this weeks appointment asked me to up my iron to twice a day, although she noted, "sometimes all that does is double the side effects without really increasing the absorption," so I'll be having bloodwork done again this coming week. She rattled off the entire results of my most recent bloodwork, but most of it meant nothing to me. The one alarming thing she mentioned and -- sort of -- explained was that my "stores" were at 6, when they should be over 100. I've subsequently been trying to figure out exactly what that means, but I can't. (Could she be referring to the mean cell volume? I have no idea...) She did say that if things don't look up, she might refer me to a hematologist.

I feel like I'm bragging when I check off my list of fears in the negative. Baby is still vertex LOA and at about a -2 or -3 station ("still ballotable" according to the PA); at this point my weight gain is a respectable 27 pounds (holding steady since 33 weeks); I'm BV-free and yeast-free; the fFN test they did Wednesday at exactly 34 weeks came back negative. For Pete's sake, I'm even still wearing my normal-sized shoes. Other than the extreme fatigue that accompanies the anemia, this has been a picture perfect pregnancy. I feel pretty good most of the time. I don't just feel like I can reasonably hope for a term baby, I'm fully expecting one.

So why does this lack of worrisome symptoms have me worried? I didn't expect, and frankly don't feel I deserve, such an easy time of it. So I keep expecting some bogeyman to jump out and surprise me. I have a nagging feeling that there's something terrible lurking that I just don't know about yet. I'm well aware that with potentially six more weeks of pregnancy ahead of me (okay, possibly even eight weeks, but please don't wish going past due on me -- it would certainly push me over the edge), there's still a lot that can go wrong. With my blood-related concerns being the only real complication so far, I'm starting to really worry about the birth. I was expecting that if I reached this point and felt as good as I do, I'd be relaxed and enjoy it, but instead I'm feeling more anxious. I'm beginning to wish that this was over soon, that May could just get here, damn it, just so I could put my anxiety to rest.

I touch the future. I... yadda yadda yadda*

I teach. I don't write much about work here, mainly because I don't want to get dooced. Yes, I admit that the real reason for avoiding discussions of my work is not because of some high moral imperative about not making fun of students and coworkers. Believe me, if it weren't for that, I'd have some real gems to share.

It just so happen to work out that my due date is two days before the last day of school this year. Virtually every single person, upon asking my due date, responds, "You planned that perfectly!" Although I've had it said to me dozens of times, I still don't have a response prepared. I usually just say nothing, or change the subject.

When I was pregnant with the Monkeyboy, his due date was mid-December, right before holiday break. A coworker remarked the familiar, "you planned that perfectly," to which I replied, "Well, when we started trying two years ago, we were aiming for May." She didn't say anything after that. I didn't mean to be curt; I just wanted to set the record straight.

I know that in terms of infertility and treatment, I've only experienced what can be considered Entry-Level Infertility Treatment (What Akeeyu calls Clomid and Fucking). We were lucky that Clomid worked for us. It's really the gateway drug of infertility meds, after all. Many people move on to bigger, scarier, more expensive and more powerful treatment. But just because on the spectrum of infertility treatment we were at the "easy" end, that doesn't mean it was easy. Not when judged in the overall fertility arena. (You know that arena, the one with events like "We got pregnant the first month trying" and "Our fourth child was an accident.")

I feel compelled to educate people about fertility and infertility (I've certainly developed a reputation as the go-to girl among friends and at work to women who have questions about getting pregnant). But, why is that? Am I really looking to "help" people and inform them, or am I looking for getting credit for my own struggles? It's probably a little of both.

So today, in my bag, I carried to school to loan to a friend and co-worker, Taking Charge of Your Fertility (book and software) and a few copies of my very own favorite BBT charts, because she is in her thirties, getting married this summer, and "wants to start right away." (Don't worry, she asked for my "help;" I'm not big on giving unsolicited advice, especially of the personal nature.) And I've told her I'll teach her "everything I know."

As a planner of things by nature, infertility has made me painfully aware that some things are out of our control. And I hate it. It's not the actual struggle to get pregnant that I hated and still resent, it's the uncertainty. If I would have been told, "it will take XX years and XX dollars and XX sometimes-painful tests and treatments to get pregnant," but there was a guaranteed baby at the end of it all, then I know that every woman suffering from infertility would say, "Where do I sign up?" But, we all know women who have sacrificed physically, financially and emotionally to treat their infertility and still are left with nothing but empty hands and a head full of unanswered questions. With years of hindsight, I'm able to realize that I'm very lucky to have been able to get pregnant at all. And planning a pregnancy is such a foreign concept to me that I just freeze at the mention of the word, dumbstruck.

So, I guess my response to the comment, "You planned that perfectly!" should be, "No, neither of my kids are planned. But they are very much wanted."

*With my apologies to the memory of Christa McAuliffe.

A Long Hallway with a Closed Door

Nothing new here, nothing to report. My cervix is still long and closed, the baby is still head down (vertex LOA, that is), the baby's heartrate is still around 138, and I've gained 1.5 pounds since last week (total gain, 27.5 pounds).

I feel so very different from how I felt at this point in Monkey's pregnancy, that I am optimistic... confident, even, that I'll go to term.* (Let's not dwell on how big this baby will be at term and how I am praying I don't go late by one second. Suffice it to say that at nearly six weeks pre-term, the Monkeyboy was not even considered low birth weight for a full term baby. And second babies are usually larger.)

I go back next week. At this point, I've had more action at my doctor's office in the last week that I've had at home in the last month. Unfortunately, it doesn't look like that's going to change.

*And this is where I should make a comment about hoping I'm not jinxing myself, but I don't feel it. Nope, just don't feel jinxy at all.

A Woman's Place is in the House... and in the Senate

I just learned Pennsylvania Senate Bill 387 left the Senate for the House of Representatives. If it passes, Pennsylvania parents of stillborn children will be able to get a certificate of birth resulting in stillbirth. I wasn't aware until very recently that in many states (and PA is apparently still one of them), parents of stillborn children do not get any sort of birth certificate at all. Trite as the expression is, there's no better way to sum it up than to say: that's adding insult to injury.

One of my oldest, best-est friends (back to kindergarten... and we were each other's maids of honors twenty years later, too) lost a son at twenty weeks gestation, so although I haven't been there personally and can't empathize, I can sympathize. Although she had C-sections for her other three children, this was the only one that she was able to deliver vaginally. She delivered him. He may not have been born live, but he was born.

As of last May, there were three states that offered birth certificates and provided tax deductions for stillborn children (Arizona, Missouri and Indiana). Seventeen states offer birth certificates for stillborn children. Seven (including Pennsylvania) are considering bills to offer birth certificates. "In the laws, the gestation period at which a fetal death is considered a stillbirth rather than a miscarriage varies among states, with some starting as early as 20 weeks."

New Mexico's governor (Bill Richardson, recent Democratic candidate for president) vetoed a bill last year to allow certificates. Part of the reason for the veto was the concern that anti-abortion advocates would use the legislation to undermine abortion rights. I understand these concerns. I'm adamantly pro-choice. I've marched for women's reproductive rights in Washington, D.C. I've helped more than a few friends sort out unplanned pregnancies, even going so far as to be the support person who drove one to the clinic on the day she terminated. I'd like to think that there's a logical answer to resolving this issues and concerns, but I know well enough that when it comes to reproductive rights, common sense seems to fly out the window. However, I'd think that the language used would be a start. A New York Times article from last year states that stillbirth is "generally defined as a naturally occurring, unintentional intrauterine death after more than 20 weeks of gestation." So, how about we start there? It's not perfect, but it's a start.

I don't have all the answers, but that doesn't mean that we should stop looking for them.

If you're from Pennsylvania, and so inclined, you can send a message of support for this bill to the House by visiting here.

Update

Fetal Fibronectin test was negative. (Insert more wooting/dancing here.)

32 Weeks

Actually, Wednesday of this week marked 32 weeks. I also had an OB appointment that day, and since I never posted an update after my 28 week appointment, I'll jam information from both into the same post.

Most importantly: The baby is head down. (Isn't this where I should insert a little "Woot! Woot! and then dance around raising the roof?) My appointment was with the Physician's Assistant (PA) who said, when I quizzed her on the baby's position, that it was a "very clear exam." So it seems, for once, I knew what I was talking about. I now have one fewer thing to obsess about, so that opens the way for all new sorts of obsessions and fears to jockey to take its place.

I almost titled this post Vagina as Petri Dish, as I have another BV infection, also known in my house as the "Holy- shit- my- water- just- broke- at- 34- weeks- infection." After checking the slide, the PA said that there was "just a little bit of bacteria," not a full-blown infection, but that she wanted to treat it anyway. I agreed. Apparently, I am just prone to having the balance of my good bacteria thrown off. (Interestingly, the Wikipedia article linked above cites a "2005 study by researchers at Ghent University in Belgium [that] showed that subclinical iron deficiency (anemia) was a strong predictor of bacterial vaginosis in pregnant women.") Luckily for me when I am not pregnant, these infections personally manifest as symptom-less, so they're not a bother. Unluckily for me when I am pregnant, these infections personally manifest as symptom-less, making it hard to detect and treat.

Just like every time I've had it, the PA seemed a little uncomfortable telling me that one reason for it is "oral relations" (her words, not mine) and that the Hubster and I have to abstain from all relations (oral and otherwise) until we both finish our rounds of Fla.gyl. She worked her face into a sympathetic, "knowing" look and said "I know it's hard." I gestured at my huge belly and said, "It's not going to be that hard; what he's going to find harder is that he has to give up drinking beer for the week he's taking the medicine."

The third thing of note was that she did do a fFN test. The results were supposed to take about 24 hours, but I haven't yet heard anything from my doctor's office. She did say if I was curious and hadn't heard from them, to give them a call (they get busy and phone calls seem to fall between the cracks sometimes), but I'm not all that concerned about it. Regardless of the results, it's not going to change anything. If I get a chance though, I'll try to call them later today just to see what the test said, out of curiosity.

As for the stats of the exam, I'm up to 151 pounds; that's a 26 pound weight gain so far (at 28 weeks, I was up to 146). At both this appointment and the last, the baby's heart rate was about 138-140. I neglected to note previously that I passed my Glucose Tolerance Test with flying colors (85), Oreos be damned! But at my 28 week appointment, after a month of iron supplements, my hemoglobin, which had been 10.1 when I was first tested for anemia, had come up to... drumroll please... 10.2. I know, impressive, right? So, although the PA said she was not worried about the implications with regards to birth (because I asked what they could be), she did send me to have repeat bloodwork done.

As for the internal exam, my cervix is still long, high and closed. Which, for the record, is exactly where I was nine days before the Monkeyboy was born and my labor with him was only 10 1/2 hours. As I said to the PA, "Dilated. Not dilated. It all means nothing to me. It made no difference last time." She agreed, saying, "You're right... every woman is different." The baby is at about a -3 station, which I can't compare to that same appointment from the Monkey's pregnancy because I don't remember her commenting on it, but it's pretty high. However, everything I've read says that subsequent babies often don't engage until labor starts.

Instead of coming back in two weeks, I will starting weekly appointments now. So next Wednesday, back I go. I keep thinking, "not that it matters..." It's not pessimism on my part, though, it's that I'm sort of at a Zen place with it all now. 32 weeks was a milestone I had in my head, that once I reached it, things would be okay. After all, at 34 and a half weeks, the Monkey did damn near fantastic. If this baby were to be born at the same gestational point the Monkey was, it would come on April 21. I think that, mentally at least, I'm ready.

The Politics of the Fetal Fibronectin Test

At my six week post-partum check-up after the Monkey's birth, I asked my OB what the chances are that I could deliver prematurely again. He guessed (and admitted it was sort of a guess) that my chances of having the same thing happen again were further increased only by about 10%.

"But there's a test we can do next time that will let us know if you have an increased risk of delivering early."

At that time two and a half years ago, I had only just heard of the Fetal Fibronectin (fFN) Test, but I assumed that was what he was talking about. So I left it at that, knowing we'd revisit the subject when it became relevant. Of course, once I became pregnant again, I started doing my own research before I even talked to my doctor about it.

Fetal fibronectin is the "glue" that attaches the fetal sac to the uterine lining. It can be present in vaginal secretions before 22 weeks gestation and after 35 weeks, but between 22 and 35 weeks it can be a signal that the bond between between the two is starting to break down and that pre-term labor may be imminent. May. Be. The most interesting fact of all is that a positive result doesn't necessarily mean anything. Other than that you will deliver a baby at some point before the end of time.

A negative result, on the other hand, is a fairly good predictor that you won't deliver within the next two weeks (although I do know of a woman who did deliver early after a negative test, as the test is only about 95% accurate -- although the company that makes the test reports it as 99.2% accurate).

So, of course, I asked my doctor about if he was still planning on using the fFN test. This was at my twenty week appointment where he checked my cervical length, as well as testing me for infections again -- all part of the slightly increased vigilance this time around. Interestingly, in the two and a half years since we had that conversation, his attitude about the test had changed.
His opinion is that the test is of limited value. The information that a positive test provides to medical professionals isn't very reliable or helpful. And that the information a negative test provides is merely just reassurance, not medically helpful. His (near)exact words were

Insurance companies love this test, because it allows them to force women who may be showing signs of pre-term labor out of the hospital, therefore saving them money. That's where the value in the test lies.

But he offered to start doing the test if it was what I wanted and if it would make me feel better. Since I could find very little information as to whether it was reliable regarding pPROM, and since I trust my doctor a great deal, I told him that it was up to him, that I trusted him, and that if he didn't think it was of value in my case, then we could skip it. A month later, at my 24 week appointment, the PA told me that she wanted to talk to the doctor about doing the fFN test soon. I didn't bother to tell he what he had just told me -- I figured they could have their own conversation, since they both know a lot more about pregnancy and childbirth than I do.* Yet another month later, as I checked out after my 28 week appointment, the nurse told me that my next appointment at 32 weeks would be with the PA, and that it would involve another internal, as they'd be checking my cervix, running cultures again to check for infections and "doing the test for pre-term labor."

Since the test doesn't actually hurt anything, I didn't question it. And after seeing the NICU bill for the Monkeyboy's stay, I'm sure my insurance will be glad to cover the $200 that the test costs. But I wonder what was said during the meeting of the medical minds that made them decide to do the test after all.

*Although, come to think of it, he's a man, and she's a young women who I don't believe has any children yet, so I bet I have a few bits of knowledge that they don't have.

Organic Milk as Calendar, Take 2

It's what I've been waiting for... Now the milk and I have the same due date.

And another thing...

I forgot to mention... following the tradition of "If it's a weird ailment or side effect, I'll get it," the Monkey was sent home from daycare last week with a fever. A fever that turned out to be Coxsackie Virus, known colloquially as Hand, Foot and Mouth Disease (or what Toddler 411 said should be called "Hand, Foot, Mouth and Butt" Disease).

Luckily, both for him and me, it's a very mild outbreak. But it just goes to show, there's never a dull moment around here.

And the obsession continues...

I've tried not to become overly obsessed by thoughts of the baby's position. But I am obsessed. I've spent countless hours googling terms like "breech head tender uterus," "frank breech movement" and "breech hiccups."

Hiccups notwithstanding, I think this little guy is vertex. In fact, in the nomenclature of Spinning Babies, I think he's LOA (Left Occiput Anterior), which seems to be the best possible position to be in.

The googling all lead to me, over the past several weeks, doing lots of pelvic rocking and even some inversions, before I remembered that the serious foot, ankle and calf swelling I had with the Monkeyboy had lead me to prop my feet and legs up every night while I lay in bed. No swelling this time has meant no propping, a major difference from my last pregnancy when I did it every night from about 24 weeks on. So, back to my version of a slant board it was (different than an inversion, since you're on your back, but there's a different principle at work). This also helped me to do some Belly Mapping.

There I was, lying on my bed, feet up on my Liberator Ramp (link is probably not safe for work, unless you have a very liberal workplace), feeling for body parts. (The Monkey wanted to do the same himself, so he used the wedge to prop his own feet up next to me). Verdict: There's the large lump near my belly button, which I probably wouldn't be able to identify clearly as either head or butt on its own. There's another large, hard lump wedged almost behind my pubic bone. But the piece de resistance was the small, hard knob right above the lower lump, which from my research seems to be a shoulder. (If you check out that link, note the excited look on the woman's face when she feels the shoulder. I bet my face looked much the same).

Hopefully.

We'll see what the professionals have to say at my appointment Wednesday (at 32 weeks).

A New Take on Infertility... A Pregnant Man

Okay, it's not really a pregnant man. Atheist in a Minivan reported on an article in the Telegraph regarding a transgender (well, sort of) couple who used their only available, functioning uterus (which just happened to belong to the husband half of the couple) to conceive. Her take on the issue is more coherent than anything I'd be able to write at this point, so go read it.

Thank you

Thank you all for your well wishes and expression of sympathy. It's getting a little easier, although it's still hard when the Monkey asks, daily if not more often, "Where's Oscar?" (actually "Whey-a Ok-kar?") holding his hands in the air like a big confused shrug. The best we can figure to tell a two-year-old is that Oscar went ""bye-bye" and is now "all gone." He seems to accept it just fine, but then completely forget until the next time that he notices Oscar is missing. (Not that I'm all that much brighter than a two-year-old, as I occasionally find myself looking for him, too.)

Worst Weekend Ever

My dog died this weekend. Oscar, the boxer that's in my profile picture with me.

He had turned nine in January, which isn't exactly old for a boxer, but isn't all that young either. Life expectancy is about 10-12 years for a healthy Boxer. However, Boxers are very prone to health problems, and Oscar had his share of them, which began just after his first birthday. Google canine idiopathic histiocytic ulcerative colitis for a start. But even though he had some chronic issues, he'd been holding his own for the last several years. Even our vet, who saw us through a great deal with Oscar (including meeting us at his office on a Sunday to treat Oscar and give his IV fluids one terrible weekend a few years ago), said that in the last few years, Oz was, ironically, the "picture of health." Looking at him, you didn't see anything other than a big, strong healthy Boxer.

He was our youngest dog, the last one we got. And so, I babied him; I spoiled him and broke all the rules for him. Like allowing him to sleep on the bed with me (which at one point cascaded into all three dogs sleeping on the bed -- that's almost 300 pounds of dog).

Oscar was a dog that never met another animal he didn't like. People, other dogs, cats, even rabbits, he was only interested in meeting them and being their friends -- he never acted aggressively once in his life. He was just a very sweet, simple dog. If you are an aficionado of Boxers, you'll know what I mean when I say, he was also a talented singer of the "Woo Woo" Song and dancer of the "Bee Dance" (also called jelly-beaning or kidney-beaning).

I'm heartbroken. Hollow. But, I also feel guilty. I don't feel we've "done right" by our dogs the last few years. Although they have a dog door and free reign of a very large, fenced, wooded yard, they spent more and more time "away" from us, no longer allowed to sleep in the bedroom (due, to some degree, to Oscar's colitis and his frequent accidents) or even roam the house freely while we're away at work. And over the last four years, dealing with primary infertility, depression, pregnancy, a pre-term baby, secondary infertility and now this pregnancy -- which has been kicking my ass -- I feel like I've neglected them even more. I'm very glad that a couple of months ago I sewed them new dog beds, larger than crib mattresses, with soft fleece on one side and full of soft stuffing. It makes me feel at least I did something right.

We were gone for the weekend, and when we came home, the Hubster found Oscar in the backyard where he had apparently collapsed and died. Our best guess is that after all these years of health-stress on his system, he suffered a heart attack or stroke. I wish I could change a lot of things, but most of all I wish we had been here.

I should have known better

There's been lots of bumping and thumping and shifting around in the last day or so, and now there are hiccups coming from right behind my belly button. Fantastic.

However, today I am only 29 weeks, so I'm making a resolution not to fret about it. I am only making guesses anyway. My next OB appointment is in three weeks. I'll see what he has to say then.

If you ask a stupid question...

The April 2008 issue of Parenting Magazine posits this "Mom Debate:"

Should a woman be able to use fertility treatments to get pregnant if she already has kids?

I'm still too tired and too busy to respond to that right now, but it's not hard to guess where I stand. You can answer the question via email at momexchange@parenting.com or click the Mom Debate link above. There's also a Community Forum where you can respond. (Last month, "more than 1,000" women answered the question regarding whether or not parents should use You.Tube to host videos of their children. Let's see if we can beat that number of responses on this, more serious, issue!)

News Flash

I think, in my in-expert opinion, that this little guy is head down. It seems like his butt is up around my belly button (I think my placenta is pretty high this time, because there are never any baby parts in the upper part of my uterus). It feels more like a butt than a head, because it's pretty hard and comes from a flat area (the back, I assume). Also, all hiccups are felt very, very low; almost behind my pubic bone.

I could be wrong*, but for right now, I'm enjoying the thought. Of course, this means I'll have to find something new to obsessively worry about. Like the fact that by writing this, I may have jinxed myself into him flipping to a less-favorable position.

*After all, I've been wrong before.

Be prepared; that's what the Boy Scouts tell me.

This weekend I pulled out the waterproof pad to protect our mattress in case my water breaks again. Last night I slept on it for the first time this pregnancy. It is not soft.

Unfortunately, words fail me again.

I just found out, via Kristen at Stickybean, that Natalie from Relaxing Doesn't Make Babies has lost her son Devin at 36 weeks gestation. At her midwife appointment yesterday there was no heartbeat and she was induced.

I find myself again asking that anyone who can stop by and lend words of support and comfort should please do so.

Float

Flogging Molly's new CD came out yesterday. Yay!

And I'm just too tired to write anything else about it. Boo.

Third Trimester

Yesterday I took the oft-dreaded one-hour Glucose Tolerance Test (GTT). The reason most women dread it is because you have to drink a fair-sized glass of thick, extra-sugary orange-flavored glucose beverage. However, since one of the cravings that's hit by the middle of each of my pregnancies has been orange flavored drinks (very, very orange: like orange Fanta and Tang), I did not look upon this appointment with dread. In fact, when the tech gave me the drink, she also set down a cup of water and said, "to rinse the taste out of your mouth." I chuckled to myself, thinking of replying, "Oh, I won't be needing that."

Today marks the first day of the third trimester; 27 weeks (although some argue that it starts at 28 weeks -- I'll take it). In recognition of that, I broke out the big, full-panel maternity jeans and donned a t-shirt that the Hubster previously told me look "gigantic and sloppy." Today, he said it just looked "slightly loose." I have finally come into my own.

My new fear (or new, old fear, I suppose, as it worried me last time for a while) is that the baby won't be vertex (head down) in time for delivery and I'll have to have a c-section. The Monkeyboy was cooperative and positioned himself head down fairly early. I think by at least 28 weeks, if not before, he was obviously vertex and stayed head down for the remainder of his tenure in womb.

This baby seems to me to be transverse (where the baby rests in the uterus like it's a hammock). I seem a little wider across the middle, not in a weight-gained way, but in a bulgy way. I feel kicks or punches everywhere: high, low, left side, right side. When I try to determine the baby's position, I can't tell. It's still kind of early, but the biggest lumps (head and back/butt) don't seem to be where they should, although they do also seem to change positions from day to day.

Last weekend was the annual Ski Weekend, where a fairly large group of us leave our kids behind and trek to the local mountains to live in sparse accomodations, drink excessively (all except me this year) and even do a little skiing (again, not me). No less than three of our friends are doctors -- the real stethoscope wielding kind. Although none of them are OB/GYNs, all three did OB rotations in med school and one is still able to deliver babies (legally certified or however that works). So I asked if they could figure out how the baby was positioned.

They all told me it was still early. However, the consensus was that, although it's hard to tell at this point (the baby is still small and has a lot of room in there), the baby feels transverse. I'm trying not to worry. I know that as the baby gets larger, the head usually gets heavy enough to convince the baby that head down is the way to go. I'm hoping he doesn't find the Jimmy-Buffet-lounging-in-a-hammock-under-a-lone-palm mood he's in to be something he wants to prolong. At my last OB appointment, the PA told me she's seen babies flip head down as late as 36 weeks. My thought? "Oh, great, that was about two weeks after the Monkeyboy was born."

Breaking 100 (into double digits)

According to my baby ticker (right), I have 99 days to go!

Just one more thing that Evonne Goolagong and I have in common

For starters, I've gained six pounds in the last month (and I was so proud of myself for only gaining one pound the month before). I had an OB appointment with the PA earlier in the week.

"How are you feeling? Do you have any questions?"

"Yes, I do. Have I really gained six pounds in the last month?"

"Well... yes you have. But you're only up twelve pounds over all, so that's fine." However, she's counting from the weight I was at when I had my first appointment at week 10. I had already put four pounds on at that point; she just doesn't know that.

I can't really complain. I've only gained sixteen pounds in 25 weeks. Even if I gain a pound a week from here on out, my total weight gain will still only be about 35 pounds, which is what I estimated it would have been if I would have gone to term with the Monkeyboy.

As for the Evonne Goolagong reference, it turns out that I, like she talked about in her Geritol commercials in the seventies, have "iron-poor blood." That is, I'm anemic.

At my last appointment, I asked my doctor to run bloodwork because I thought I might be anemic. I am beyond fatigued. Not just exhausted, but I've even been feeling muscle weakness. I am cold all the time (I've been running a little space heater by my desk at work to try to get warm). I'm irritable. I have a hard time concentrating. I'm out of breath. The other night I walked across the house to check on the Monkeyboy before going to bed and when I laid down, my heart was racing. And I look like a corpse; I'm pale and have dark circles under my eyes that aren't easily covered with makeup. Purpley-blue dark circles accentuated by my pale, pale, almost translucent skin. Call it vampire-chic.

Many of these are not unusual symptoms for pregnancy, but I've been pregnant before and the level of the symptoms was unusual for me. My doctor agreed, and because I've been feeling so cold all the time, he even said he'd throw a TSH check in with my CBC, just for fun. I doubted I was hypothyroid because I didn't have any of the other symptoms (we used to have a dog that was hypothyroid, so I'm familiar with the symptoms), but I was willing to look for anything that was making me feel this way.

Due to a snafu with our home phone*, I didn't get the message from my doctor's office regarding my bloodwork. I assumed nothing out of the ordinary presented itself. Imagine my surprise when the PA opened my appointment with a glance at my chart and the question, "So, have you been taking the iron?"

My hemoglobin was 10.1, which is low, but not extremely low.** The normal range of hemoglobin in non-pregnant women is 12.3 to 15.3; the WHO defines anemia in non-pregnant women as less than 12. A level of 10.0 and 10.9 is considered mild anemia in pregnant women. I am low enough that I'm now taking iron supplements and will have it rechecked at my 28-week bloodwork (which also includes my glucose tolerance test).

I've already been taking an additional 250 mg of vitamin C, since there's some evidence to show that vitamin C helps prevent pPROM. However, very high levels of vitamin C have also been found in women who've miscarried. (I cannot find my sources for this, though. I will keep looking.) That's why I've only been taking 250 mg (which was the smallest dose I could find), instead of the usual mega-dose options available at the average grocery, health food or big-chain stores.

Vitamin C helps the absorption of iron, so I'm now taking them at the same time each day, a time which is at least two hours after I've consumed any dairy products and at least two hours before I will consume any more (since calcium blocks the absorption of iron). This has been difficult, because I drink -- and I swear I am not exaggerating here -- about two quarts of milk a day (much of it chocolate). I have a tall glass as part of my breakfast, a chocolate milk as my after-lunch snack, a glass when I get home from school/work and have a snack, sometimes another glass in the evening and then I wrap up the evening with my pre-bed glass-of-milk-and-a-cookie/brownie routine. Finding a dairy-free time to take the iron supplement has been the biggest challenge so far. Looking at my milk-drinking schedule, and knowing calcium's anti-iron attitude, is it any wonder that I am anemic? But certainly not calcium-deficient, oh no.

Hopefully, the iron supplements will take hold and my anemia, along with its symptoms, will be a thing of the past. Then the only thing Evonne Goolagong and I will have in common is that we're both retired international tennis superstars and daughters of itinerant sheep shearers. And frankly, isn't that enough?

*It can take upwards of two weeks for two adults with cell phones to realize that their land line is not working; no dial tone, nothing. Ah, the blessing and curse of modern technology.

**Although a woman at work said her elderly mother was admitted to the hospital when her hemoglobin reached 9.

There are a lot of things I understand...

But even more that I don't.

Of all the searches that point people in this direction, for most of them, I understand what they mean and why people ended up here:

• ligament pain (Here we go round the ligament pain)
• sirius wilco (I have tried to like Wilco)
• sore belly after amnio (Amnio)
• Mary J. Blige hcg (iPod Playlist in sidebar/Obsessing on hCG levels)
• aslyn rock boat 7 track listing (Lazy Mix CD)
• opk control freak (On to an RE)
• clomid estradiol and prochieve together (August 2007 archive)
• eeeeww (All I can say is... Eeeeww)
• Omega 3-6-9 TTC success (August 2007 archive)
• organic milk expiration (Organic Milk as Calendar)
• boring summer jobs (Most. Boring. Summer. Ever.)
• negative facts about cell phones (Cell phones)
• nuchal transluscency blog (Nuchal Transluscency)
• social distortion maternity (Bored now.)
• infant crying cat vomit* (Crying Baby, Puking Cat)
• How much did Ryan Reynolds weigh in Blade III (My List)
• first trimester craving steak (Place your bets)
• irony of procrastination (Procrastination/Irony)
• All the various music-related searches (Aslyn, Slaid Cleaves, Chris Trapper, Zac Brown, Warped Tour, etc)

And even...

• What color is the sky in your world cliff claven (No News is Good News)

But the ones I do not get?

• didgeridoo pregnant
• didgeridoo miscarriage

(Okay, I understand why they ended up here, but not what the hell that search could have been looking for.)


*My personal favorite search. It's so close to "Crying Baby, Puking Cat" I wouldn't be surprised if I was at the top of the search list for that one.

24 Weeks

Yes, as of today, I've reached the big "24 weeks" viability milestone. (Or as of yesterday, according to my OB, who uses last menstrual period instead of ovulation to calculate due date).

A great deal is made of this milestone on pregnancy forums (and by some doctors), and although I'm glad to have reached it, I know that it's really no guarantee that a baby born this early would survive. The March of Dimes website's Fact Sheet on Preterm Birth doesn't even give a survival rate for a birth at 24 weeks (the earliest they give statstics for is 26 weeks, at which the survival rate is 80%, although 25% of these babies will have serious, lasting disabilities).

So, for me the relief is only in knowing that at least the baby would have a chance and the hospital would be willing to fight for him.

By 28-31 weeks gestation, the survival rate climbs to 90-95 %, so 28 weeks is the next real milestone to which I'm looking forward. I have a real-life friend whose son was born at 30 weeks last spring and he's doing well. He spent two months in the NICU and another month in a step-down facility before coming home. He was also on an apnea monitor at home for several months, and has made several return stays in the hospital (most recently for croup), but overall is doing well. I also know a make-believe friend who has a 3-year-old 30-weeker who is bright and healthy (the woman is real, its only the part about calling her a friend that's the make-believe part, since I only stalk her via the internet). So although delivery at 30 weeks is still a rough road, that's when I'll start to feel even a tiny bit comfortable.

Of course, 34 weeks is when I feel the most comfortable. Completely comfortable, if you want to be honest, and probably more comfortable than I should. Not only were Old Christine's twin sons born at 34 weeks (12 day NICU stay and now the healthiest 10-year-olds I know), but the Monkeyboy was born at 34 weeks (5 days in the NICU). Technically, you're not out of the woods at 34 weeks, but the Monkeyboy was an ounce over what's considered low birthweight (he was 5 pounds, 9 ounces), didn't use a second of oxygen and could nipple all of his feedings (with help). In the grand scheme of things, he was barely a preemie. But it was still stressful. He was hooked up to monitors and slept in an incubator. He didn't come home with me. Breastfeeding was a challenge at first because he wasn't ready and needed help. We worried about his health, he had extra checkups and weigh-ins, and got the RSV vaccine. He had some delayed milestones the first year.

And 34 weeks is still ten weeks away.

Excuse me for sounding pessimistic. Today I'm wearing a red maternity shirt I bought while pregnant with the Monkeyboy. I bought it so I had something that looked somewhat festive to wear around Thanksgiving and in December 2005. This morning I took off the tags and wore it for the first time.

Words fail me

Mary Ellen and Steve over at Not According to Plan just lost their triplet girls, Sylvia, Claire and Lucy at 19 weeks. Anyone who can stop by and lend words of support and comfort should please do so.

Sexual Politics

Thoughts of the coming election, mingled with those of parenthood, keep bringing to mind Anne Lamott's memoir of her son's first year and this quote from it:

Then I called a woman who went out with him a few years ago and discovered the two most damaging things I can know about a man: one, he voted for both Bush and Reagan, and two, he was very reluctant to give head. Now maybe on a really bad night I would let one of these things go by, but I tell you, if his head wouldn't go south of my waist and he was up there talking with passion about the thousand points of light, I'd crack. It would be like "Hey, thanks for stopping by, pal, but the thousand points of light are in my pussy." I don't want to negotiate the SALT talks just to get a little oral sex. The right guy will love nothing more.

-- Anne Lamott, Operating Instructions

Christmas in January*

What does it say about me as a mother that I'm reluctant to pay full price for Carter's fleece footie pajamas, at $14.99 for two pair, but OldChristine bought the Monkeyboy Hannah Anderson jammies for Christmas that were almost $40 for just one pair?


*We typically "do" Christmas with our best friends at least a month after the date. It just always seems to work out that way, scheduling-wise. (One year we did it in April!)

Send good thoughts

I'm not much of a praying person, but I'm keeping my fingers crossed (The Atheist's Prayer, I call it) for Alexa. She's on my Spring Due Dates blogroll, 24 weeks pregnant with twins. Her son died in utero last week and this morning his water broke, endangering her daughter who is still hanging on. Send your thoughts/prayers her way.

I'm starting to take this personally

I don't want to keep bringing this up, but one more thing about Heath Ledger. The Mary Kate Olsen connection? I'm beginning to think that the Olsen girls are going after My List, one by one.

Opening Available

I'm unreasonably upset about the death of Heath Ledger. (Actually, the Hubster says that "any level of upset about his death qualifies as 'unreasonable'.") I'm not as upset as I was at the sudden death of Phil Hartman*, but the feeling of shock at learning of his death was the same. It just came out of nowhere.

I'm not much of a celebrity-watcher, but I always have a few favorites. I've enjoyed Ledger's performances in movies (with, perhaps, the exception of A Knight's Tale). I've even used the movie The Patriot in my Revolutionary War unit several times (although it's flawed, it has its merits). Brokeback Mountain broke my heart. It also doesn't hurt that, day-um, Heath Ledger was hot (that's with a capital-H-a-w-t). On a personal level, I can't stop thinking about the fact that his daughter was born only a few days before the Monkeyboy, so he's one of several celebrities with whom I shared a pregnancy. It's an odd association, I know, but I remember those who were pregnant when I was. It originally came to my attention back when another woman on a pregnancy forum I frequent posted that Ledger and Michelle Williams had been in the group that took the hospital tour when she and her husband did. I just can't stop thinking about his little girl. I think that if something happened to me, the Monkeyboy is just too young to remember me at all.

When I told the Hubster that he had died, his immediate response was, "Wow. Well, that opens up a spot in your Bottom Five, now doesn't it?" And as usual, he really gets right to the heart of the matter.


*You may remember his character Troy McClure from such educational films as "Designated Drivers: Lifesaving Nerds" and "Locker Room Towel Fight: The Blinding of Larry Driscoll."

Honestly, I read it for the articles

In Play(boy)'s Advisor column last month, there was a question regarding breastfeeding etiquette. A woman wrote regarding her best friend's habit of breastfeeding in front of the writer's boyfriend because, "even though my friend does her best to shield his view," the boyfriend is uncomfortable.

The Advisor's response?

Your boyfriend will have to deal. Seeing a little tit never hurt anyone.

Amen, brother.

Lyrically Speaking

In recognition of the bloody cold weather we've been having the past few days...

She plays Beach Boys records and she dances alone,
And before (before) before she goes home...
She wants a Piña Colada in a pint glass...
She wants to be where the summer won’t stop,
She wants gin clear water and milk white sand,
A sunburned nose and a drink in her hand
With a pink umbrella on top!

-- Gaelic Storm, " Piña Colada in a Pint Glass," How Are We Getting Home? (2004)

Parenting of Least Resistance

The other day I was lying on the couch while the Monkeyboy played with his balls. (No, not those ball. Get your mind out of the gutter.) The boy has a serious ball fetish, like my sister-in-law's cocker spaniel used to have. The ball of preference varies from week to week or month to month. For example, over the summer, he took to sleeping with his football. He decided on his own that this was something he wanted to do, and since a football in his crib seemed very low of the scale of things-that-should-never-be-put-into-cribs-with-young-children, the Hubster and I figured, Why not? We did comment to each other that we would have been embarrassed should anyone outside the family find out, lest it seem like we were deliberately trying to craft the next generation Joe Montana. We have no plans to be that kind of parent.

As the school year progressed, he abandoned the football for a variety of other, more hand-sized models. Currently, he prefers tennis balls, whiffle golf balls (yeah, the regular golf balls didn't quite work out for him, as he also likes to throw things with the arm of Ebby Calvin "Nuke" LaLoosh, both in terms of speed and accuracy), and the little plastic cannonball that came with his Fisher Price Pirate Ship this Christmas.

Getting back to my original thought, though, was that as he played in our Great Room with those toy balls, they often found their way beneath our behemoth of a couch. After rousing myself a couple of times to drag them out, I decided that the time had come for my son to learn some skills to allow him to problem solve on his own. I got out his toy broom from the laundry room, and showed him how he could use it to fish things out from under the couch.

You know what they say, Give a man a fish; you have fed him for today. Teach a man to fish; and you have fed him for a lifetime. Except my motivations were not quite so altruistic. I just didn't want to get my tired, pregnant butt up off the couch again.

Halfway

Today I am 20 weeks. The high water mark of pregnancy, both in terms of time frame and, for me, how I feel. With the Monkeyboy, I felt pretty good at twenty weeks, but it went slowly downhill from there. Right now I'm feeling pretty good, but based on experience I assume this is the calm before the storm.

My level II ultrasound was at 18 weeks 1 day. Everything looked good and we were even able to get a shot of the little guy's naughty bits, although we already knew what model baby we were getting. The one issue of concern for me is that all the measurements the tech took were over 19 weeks; they ranged from 19 weeks 1 day to 19 weeks 5 days. That's a big baby.

At my next OB appointment (a week from today), I'll be raising that issue with my doctor. At the Monkeyboy's delivery he told me (with his hands between my legs), "It's a mixed blessing that you're delivering this early, because you're very small down here.* This birth might not have been so easy if this was an eight pound baby."

By his due date, the Monkeyboy was eight pounds, three ounces. So now I have the contradictory fears of 1) another premature birth and 2) going to term. I'd rather not be induced if I get that far, but I also don't want to go to term with a huge baby,** and then push for three hours before having them tell me, "Sorry. Cephalo-pelvic disproportion. Emergency C-section." If I have to have a C-section this time, I'd rather it be planned.

One of the stressful things about this pregnancy and birth is that I sort of feel like I've never done this before. With my first pregnancy, I thought, I could go to term, or I could go over due, who knows? I've never done this before. But I still feel that way, except now I think, I could go early, I could go to term, or I could go over due. Who knows? I still feel like the impending birth is a big giant wild card.

*He didn't seem to find any humor in my "Thanks, that's what all the guys say" response.
**"Huge" in relation to lil ol' me, that is.

Stopping by the Woods on a Snowy Evening. Unfortunately.

What the fuck is wrong with some people? Vandals Rip into Robert Frost Home

The intruders broke a window to get into the two-story wood frame building -- a furnished residence open in the summer -- before destroying tables and chairs, pictures, windows, light fixtures and dishes. Wicker furniture and dressers were smashed and thrown into a fireplace and burned, apparently to provide heat in the unheated building...

Hopefully, for some people, prison will turn out to be the place where, when you have to go there, they have to take you in.

Milestone?

17 weeks, 2 days. At this point in my last pregnancy, I was halfway and didn't know it. (Actually, that would technically be 17 weeks, and 2 1/2 days, but close enough). Just another of the big "Wait-and-Sees" of pregnancy.

Nevermind...

Wow! The amnio results came in extra quick (eight days). Everything's normal, 46 chromosomes, no more, no less and.... another boy!

All I can say is, my house is going to be like a rodeo if this one's anything like the Monkeyboy.