Spent some time in Labor and Delivery today without laboring or delivering

I went to my regular appointment with one of the midwives this afternoon. While I was waiting in the exam room laying back on the table I started seeing spots. This has happened in the past but never with any of the other preeclampsia symptoms, so the midwives have always told me to pay attention to it and look for the other signs but they weren't too worried. Preeclampsia is a pretty serious problem in pregnancy and can get very serious if not treated. The only treatment is delivering the baby so even if I had a fairly mild case I would be induced since I'm already at 40 weeks and it's not worth finding out if it's going to get worse. This week my feet were also huge as I showed you all before and my blood pressure was high (138/90). Last week it was high when I first got to the appointment and they rechecked it before I left and it had gone back down again. Susan (midwife) thought that since I'm 40w I should just go over to be fully checked out and make sure everything was OK.

So we walked across the street to the hospital and to labor and delivery. It was 4:30 PM. So we got in and a nurse got me all set up. They put the monitors on my stomach so we could hear and watch the heart beat and watch my contractions. It was cool to see how high my contractions were registering compared to what I could feel (which was almost nothing). They also had me hooked up to a blood pressure cuff that would take my blood pressure every 15 minutes. I peed in a cup and they took a few tubes of blood from me. Then they just wanted me to hang out. They said it would take an hour to two to get all my blood work back so we waited. They ordered dinner for me but of course not for Scott. I shared with him a little bit of my pizza though but he was still starving by the time we left. He was really good and supportive while we were there though.

So everything came back totally normal. They don't think it's preeclampsia at all. They just told me what to look for and to call if I experience any symptoms again. They checked me and I'm only 1 cm dilated. That kind of stinks but at least it's something. They did an ultrasound too and baby looks good. She was practicing breathing. Her diaphragm was moving up and down. Before she's born she gets all of her oxygen through the umbilical cord but babies practice breathing amniotic fluid in and out to prepare their lungs for actual breathing. So it was good to see her doing that. The OB thought she looked pretty big. She said she had long legs. The ultrasound measurements put her at 8 lbs 12 oz. The OB didn't think she'd be that big though. She felt her from the outside of my belly and thought she was more like 8 lbs or high 7s. She said there was a lot of variation in the estimates the ultrasound gives.

So I still have my appointment a week from today. My parents were planning on coming down tomorrow but now they're going to hold off a little bit and see what happens in the next day or so first. Hopefully she'll decide to make her arrival soon.

A couple of blurry pictures from the cell phone camera of me relaxing in the triage room:

the worst part about pregnancy

The worst part of pregnancy so far is the swelling. I think my feet are fatter than my legs are. I'm hoping that this will go away very, very soon after delivery. None of my shoes fit--even Crocs are tight, they are ugly, and they hurt--I can barely bend my toes and walking is uncomfortable. You can even see indentations in my feet from my my flip flops.

Baby shower #2

My fabulous coworkers threw me a baby shower a couple of weeks ago. They, of course, went way over the top. Lots of people were there and I was very overwhelmed. Here are some of the highlights:

The decorated conference room.

Sitting at the head of the table full of gifts.

The personalized M&Ms they had made for me.

The M&Ms were in little bags for everyone to take.

Really yummy red velvet and vanilla cupcakes from Sprinkles Cupcakes.

The room full of people watching me.

Opening gifts.

It was a wonderful afternoon. I was surprised and overwhelmed and very thankful to Amy, Rebecca, Alison, Alex, Katy, Matt and Dr. Marder for putting so much work into everything and making me feel so important. And thanks to everyone who came and all the wonderful gifts.

The due date is here!

How your baby's growing: It's hard to say for sure how big your baby will be, but the average newborn weighs about 7 1/2 pounds (a small pumpkin) and is about 20 inches long. His skull bones are not yet fused, which allows them to overlap a bit if it's a snug fit through the birth canal during labor. This so-called "molding" is the reason your baby's noggin may look a little conehead-ish after birth. Rest assured — it's normal and temporary.

How your life's changing: After months of anticipation, your due date rolls around, and... you're still pregnant. It's a frustrating, but common, situation in which to find yourself. You may not be as late as you think, especially if you're relying solely on a due date calculated from the day of your last period because sometimes women ovulate later than expected. Even with reliable dating, some women have prolonged pregnancies for no apparent reason.

You still have a couple of weeks before you'll be considered "post-term." But to be sure your baby is still thriving, your practitioner will schedule you for testing to keep an eye on her if your pregnancy continues.

You may have a biophysical profile (BPP), which consists of an ultrasound to look at your baby's overall movements, breathing movements (movement of her chest muscles and diaphragm), and muscle tone (whether she opens and closes her hand or extends and then flexes her limbs), as well as the amount of amniotic fluid that surrounds her (important because it's a reflection of how well the placenta is supporting your baby).

Fetal heart rate monitoring (called a nonstress test or NST) will generally be done as well — by itself or as part of the BPP. Or, you may have what's known as a modified BPP, which consists of an NST and an ultrasound to assess the amount of amniotic fluid.

If the fetal testing isn't reassuring — the amniotic fluid level is too low, for example — you'll be induced. If there's a serious, urgent problem, you may have an immediate c-section.

Your practitioner will also check your cervix to see if it's "ripening." Its position, how soft it is, how effaced (thinned out) it is, and how dilated (open) it is can all affect when and how your labor is induced. If you don't go into labor on your own, you'll be induced, usually sometime between 41 and 42 weeks.

How I'm doing: Well our due date is here. I'm not too surprised we made it this far. We were pretty sure that we'd make it to this point at least. I'm still feeling pretty good. The house is pretty much in order and I think I'm doing a pretty good job of staying on top of things. My to-do list is getting shorter and shorter. We had an appointment with one of the midwives this week. The baby is doing fine. Her heartbeat was nice and strong. Our next appointment is on Wednesday; we're hoping we don't make it to that point. If we make it to that point, we'll go in twice a week and do some more tests to make sure the baby is still thriving and that my body can still support her. We shouldn't start talking about induction until 41 weeks. Thankfully my midwives have a due date a few days later than I do so our window is a little longer.

I have been feeling some contractions. Unfortunately, that's not really indicative of anything except my body is preparing for labor. We don't go to the hospital until I'm having contractions that are four minutes apart, one minute long and last for an hour.

Hopefully there won't be another weekly update; just a birth announcement from the hospital. We can remotely post messages from my cell phone so we should announce the birth here shortly after it happens.

39 weeks - Happy Passover!

How your baby's growing: Your baby's waiting to greet the world! He continues to build a layer of fat to help control his body temperature after birth, but it's likely he already measures about 20 inches and weighs a bit over 7 pounds, a mini watermelon. (Boys tend to be slightly heavier than girls.) The outer layers of his skin are sloughing off as new skin forms underneath.

How your life's changing: At each of your now-weekly visits, your caregiver will do an abdominal exam to check your baby's growth and position. She might also do an internal exam to see whether your cervix has started ripening: softening, effacing (thinning out), and dilating (opening). But even armed with this information, there's still no way for your caregiver to predict exactly when your baby is coming. If you go past your due date, your caregiver will schedule you for fetal testing (usually a sonogram) after 40 weeks to ensure that it's safe to continue the pregnancy. If you don't go into labor on your own, most practitioners will induce labor when you're between one and two weeks overdue — or sooner if there's an indication that the risk of waiting is greater than the risks of delivering your baby without further delay.

While you're waiting, it's important to continue to pay attention to your baby's movements and let your caregiver know right away if they seem to decrease. Your baby should remain active right up to delivery, and a noticeable slowdown in activity could be a sign of a problem. Also call if you think your water may have broken. Membranes rupture before the beginning of labor in about 8 percent of term pregnancies. Sometimes there's a big gush of fluid, but sometimes there's only a small gush or a slow leak. (Don't try to make the diagnosis yourself. Call even if you only suspect you have a leak.) If you rupture your membranes and don't start contractions on your own, you'll be induced.

How I'm doing: I'm glad to be off work now. I'm a lot more tired and walking is a lot slower and a little uncomfortable--sometimes more than others. I had an appointment with a midwife on Wednesday. My group B strep test came back negative. Good news. So I won't need to get IV antibiotics during labor. She also advised me to start taking naps everyday to get used to sleeping during the middle of the day so I'll be able to sleep when the baby sleeps. I've taken her advice a couple of times already. I do get tired after I exert myself at all. I'm still trying to get a few things done but I have to take a lot of breaks during the day to relax or nap. I have been able to get a few things done each day though. I think I have 8 or 10 meals in the freezer for the days after guests leave and I'm still too exhausted to cook. I have a couple of chicken pot pies, lasagnas, taco meat, and chicken and rice casseroles. Plus instructions for Scott about how to prepare everything. I worry that otherwise we'll be eating KFC and McDonald's every night since they are right down the street. Other than that, I'm just trying to stay on top of the laundry. Two loads a day is my max since that's the most I can carry at one time and I'm not willing to walk up and down two flights of stairs any more than is necessary.

We celebrated Passover at home today. We were invited to the Eisenberg's in San Diego but we decided that was too far to drive so close to my due date. Delivering at an unfamiliar hospital with unfamiliar health care providers is something I really didn't want to risk. We worked very hard to find providers that matched our views and didn't want to risk not delivering with them. Especially since tomorrow is a full moon! So we had our first Passover at home; just the two of us. It was actually quite nice, we had matzoh ball soup, brisket, steamed broccoli, charoset and then chocolate covered matzoh for dessert. We even ate on our wedding china for the first time.

Here's our Passover table (all ready for a little baby to join us):


And me, next to the table:
Someone asked me if I was having twins the other day. I don't think I'm that big, I've seen MUCH bigger. An hour before that some (nicer) woman told me I didn't even look pregnant from the back.

Charlie likes matzoh and the bitter herbs too:
Tomorrow is a full moon. Apparently, this old wives tale IS somewhat true. We're hoping that means I'll go into labor. No real signs of that happening yet. Baby seems to be running out of space though. She's really been pushing out against my right side. We keep telling her she needs to move down, there's no exit out my right side. We are, of course, anxious to meet her.

38 weeks

How your baby's growing: Your baby has really plumped up. She weighs about 6.8 pounds and she's over 19 1/2 inches long (like a leek). She has a firm grasp, which you'll soon be able to test when you hold her hand for the first time! Her organs have matured and are ready for life outside the womb.

Wondering what color your baby's eyes will be? You may not be able to tell right away. If she's born with brown eyes, they'll likely stay brown. If she's born with steel gray or dark blue eyes, they may stay gray or blue or turn green, hazel, or brown by the time she's 9 months old. That's because a child's irises (the colored part of the eye) may gain more pigment in the months after she's born, but they usually won't get "lighter" or more blue. (Green, hazel, and brown eyes have more pigment than gray or blue eyes.)

How your life's changing: For many women, the next couple of weeks are a waiting game. Use this time to prepare your baby's nursery or to take care of necessary tasks you may not get around to for a while after your baby's born. Take naps, catch up on your reading, and spend uninterrupted time with your partner while you can.

Some swelling in your feet and ankles is normal during these last weeks, but call your practitioner without delay if you notice excessive or sudden swelling of your feet or ankles, more than slight swelling of your hands, any swelling in your face or puffiness around your eyes, or have a sudden weight gain. Also let her know immediately if have severe or persistent headaches; visual changes (such as double or blurred vision, seeing spots or flashing lights, light sensitivity, or a temporary loss of vision), intense upper abdominal pain or tenderness, or nausea and vomiting. These are symptoms of a serious condition called preeclampsia.

How I'm doing: Today was my first day of maternity leave. So far it hasn't been all that relaxing. I had a bunch of errands today and my 38 week appointment with the midwives so I didn't get a lot of rest. Our midwife said I need to nap during the day to get used to getting some sleep during the middle of the day since when the baby comes I'll need to sleep when she sleeps. The baby is doing well. Her head is still down. Her back was running along my left side. Her heartbeat was nice and strong at about 137 bpm. My belly growth is right on track and I didn't gain any weight in the last week. I might not gain any more at end and might even lose a little.

I might be done with my yoga classes until the baby comes. My instructor is away on a trip to London so there are substitutes for the next two weeks. So I might just do some yoga at home every day. I always do my cat/cow poses each morning (imagine being on your hands and knees and then alternating between mooing into the sky and arching your back like a cat stretching).

I was quite sad to leave work actually. More than I expected. It is strange to think about not going in for so long. I'm sure my mind will be focused on other things once the baby gets here but for now it's weird. Plus there's a lot going on at work and it's hard not to think and worry about things getting done.

Happy Passover!

The baby pool

http://www.expectnet.com/games/BabyGirlPope

If you'd like to earn bragging rights, you can add your guesses to the pool click the banner above or copy and paste the link. If you want to try and make a guess for the name, you can guess a letter or a full name by commenting to this post. If anyone gets the full name right there might be a special prize. The only hint is that she will have only 1 1st and 1 middle name. Good luck!

37 weeks - Full Term!

How your baby's growing: Congratulations — your baby is full term! This means that if your baby arrives now, his lungs should be fully mature and ready to adjust to life outside the womb, even though your due date is still three weeks away.

Your baby weighs 6 1/3 pounds and measures a bit over 19 inches, head to heel (like a stalk of Swiss chard). Many babies have a full head of hair at birth, with locks from 1/2 inch to 1 1/2 inches long. But don't be surprised if your baby's hair isn't the same color as yours. Dark-haired couples are sometimes thrown for a loop when their children come out as blonds or redheads, and fair-haired couples have been surprised by Elvis look-alikes. And then, of course, some babies sport only peach fuzz.

How your life's changing: Braxton Hicks contractions may be coming more frequently now and may last longer and be more uncomfortable. You might also notice an increase in vaginal discharge. If you see some "bloody show" (mucus tinged with a tiny amount of blood) in the toilet or in your undies, labor is probably a few days away — or less. (If you have heavier spotting or bleeding, call your caregiver immediately.) Also be sure to ask your caregiver about the results of your Group B strep culture. That way, if the result isn't yet on your chart when you get to the hospital or birth center, you'll be able to give the staff there a timely heads-up if you need antibiotics.

It may be harder than ever to get comfortable enough to sleep well at night. If you can, take it easy through the day — this may be your last chance to do so for quite a while. Keep monitoring your baby's movements, too, and let your caregiver know immediately if you notice a decrease. Though her quarters are getting cozy, she should still be as active as before.

While you're sleeping, you're likely to have some intense dreams. Anxiety both about labor and about becoming a parent can fuel a lot of strange flights of unconscious fancy.

How I'm doing: I'm excited to have made it to 37 weeks. The baby can come any day now. I still have 7 more days of work though (Tuesday, April 15th is my last day). I'm excited for that day to come because it means the baby is almost here but I'm also a little sad. It's going to be very weird to be off work for 4 months or so. I haven't been off work/school for 4 months since I started going to school in 1984. I'm sure I'll be so distracted I won't notice. And I'm sure I'll stop by a few times to show off the baby.

Speaking of work, my work buddies threw me a surprise shower on Wednesday of this last week. I knew they were planning something but I didn't know what or when. They planned it to take place during our regular weekly group meeting--which I kind of had a feeling it might fall during that time since we're all gathered then. BUT, it was much more than I expected. Lots of balloons, pink tablecloths, decorations, Sprinkles cupcakes, and personalized M&Ms. That and a lot of people focused on me for an hour. I was very overwhelmed with the generosity displayed. Baby Pope got a lot of nice gifts. A lot more books and clothes, her swing, cute and tiny shoes, lullaby CDs and a lot more. She's definitely a spoiled little girl already. Thank you to the "HSU" (which is my work group at the VA, the Health Services Unit) and especially to Amy, Rebecca, Alison and Katy who I think were the major conspirators. Apparently Scott knew about this for several weeks and was able to keep it a secret and even taunt me asking me if I'd looked at any of our registries recently. He's a better liar than I've given him credit for in the past. Thanks again, I'm really lucky to work with really great people.

We also had an appointment with our midwives this last week. We talked to them again about their "overdue" protocols since most likely I'll end up being late and not early unfortunately. Unlike a lot of prenatal providers, our midwives do not do regular internal exams until I'm 41 weeks pregnant (or 1 week "overdue"). A lot of providers will start to do exams at around 36 weeks. This is why some women can give updates about how dilated and effaced they are before they're actually in labor. The problem with this is that dilation and effacement don't really tell you anything about when labor will start. It's possible to walk around 3 cm dilated for several weeks and it's possible not to be dilated at all and go into labor later that day. So it gives people false hopes or unnecessary grief knowing this number. FYI- effacement refers to how thin or short the cervix is. The cervix needs to open (dilate) and shorten (efface) before the baby can be delivered. The cervix dilates to 10 cms and effaces to 100%. Our midwives will not start talking to us about induction at all until I reach that 41 week appointment. At that point, we'll see how the baby is doing and go from there. If my amniotic fluid levels are good, the baby seems happy and is not losing weight we'll hold out until about 42 weeks. Things start to deteriorate at 42 weeks so induction would be in the cards at that point. Hopefully we won't make it that far. The new hospital opens at 40 weeks 4 days. We don't want to have this baby during the transition. I don't really want to be wheeled to the new hospital while I'm in labor or shortly after birth.

My next appointment with the midwives is on Wednesday morning. I'm meeting with them weekly now until the baby comes. At this appointment I'll get my group B strep test done. Remember I'm hoping for this to be negative so I don't need IV antibiotics during labor which would make me more confined to the bed. But if I am positive this could mean a chance of some nasty things happening to the baby if I'm untreated so we'll definitely go for the antibiotics.

I've still been having contractions a couple times a day. Nothing really notable about that. I'm also still going to yoga twice a week when I can. This morning I went to water aerobics and yoga. In my water aerobics I got a lot of "advice" from an older woman who thought I shouldn't be doing anything but sitting at home I guess. Thankfully she didn't stay through the whole class. Just like anyone else I can tell when I'm pushing myself too hard and I don't do it. Exercising makes me feel better not worse. We had our last birth class this last Thursday. Technically speaking we should know how to birth this baby now. We'll see how much we learned sometime in the next month.

36 weeks

How your baby's growing: Your baby is still packing on the pounds — at the rate of about an ounce a day. She now weighs almost 6 pounds (like a crenshaw melon) and is more than 18 1/2 inches long. She's shedding most of the downy covering of hair that covered her body as well as the vernix caseosa, the waxy substance that covered and protected her skin during her nine-month amniotic bath. Your baby swallows both of these substances, along with other secretions, resulting in a blackish mixture, called meconium, will form the contents of her first bowel movement.

At the end of this week, your baby will be considered full-term. (Full-term is 37 to 42 weeks; babies born before 37 weeks are pre-term and those born after 42 are post-term.) Most likely she's in a head-down position. But if she isn't, your practitioner may suggest scheduling an "external cephalic version," which is a fancy way of saying she'll try to coax your baby into a head-down position by manipulating her from the outside of your belly.

How your life's changing: Now that your baby is taking up so much room, you may have trouble eating a normal-size meal. Smaller, more frequent meals are often easier to handle at this point. On the other hand, you may have less heartburn and have an easier time breathing when your baby starts to "drop" down into your pelvis. This process — called lightening — often happens a few weeks before labor if this is your first baby. (If you've given birth before, it probably won't happen before labor starts.) If your baby drops, you may also feel increased pressure in your lower abdomen, which may make walking increasingly uncomfortable, and you'll probably find that you have to pee even more frequently. If your baby is very low, you may feel lots of vaginal pressure and discomfort as well. Some women say it feels as though they're carrying a bowling ball between their legs!

You might also notice that your Braxton Hicks contractions are more frequent now. Be sure to review the signs of labor with your practitioner and find out when she wants to hear from you. As a general rule, if you're full-term, your pregnancy is uncomplicated, and your water hasn't broken, she'll probably have you wait to come in until you've been having contractions that last for about a minute each, coming every five minutes for an hour. Of course, you'll want to call right away if you notice a decrease in your baby's activity or think you're leaking amniotic fluid, or if you have any vaginal bleeding, fever, a severe or persistent headache, constant abdominal pain, or vision changes.

Even if you're enjoying an uncomplicated pregnancy, it's best to avoid flying (or any travel far from home) during your final month because you can go into labor at any time. In fact, some airlines won't let women on board who are due to deliver within 30 days of the flight.

How I'm doing: I'm definitely starting to slow down. I walk much slower than I used to and get tired a lot quicker. I think this is partly due to just carrying around so much extra weight and also because I can't take a deep breath in. I don't think the baby has dropped yet but I'm looking forward to that soon so I have some lung capacity back. Even a few weeks ago I couldn't imagine the baby being high up enough to "kick me in the ribs" like pregnant women often talk about but now that happens all the time. My belly now starts above the bottom of my ribs. This reduced lung capacity also makes things like sneezing, coughing and yawning a lot less satisfying and sometimes a little painful if I inhale too much air.

I have been having Braxton Hicks contractions fairly regularly. Usually at least a few times a day. For me they feel a little bit like a menstrual cramp that comes and goes in waves. They aren't really painful but definitely don't feel pleasant. A couple of nights ago I had about 8 in a row that lasted for almost a minute and were every 3-4 minutes. I knew I wasn't in real labor because they didn't hurt, I could still do something else during the contraction (I didn't have to concentrate), and as soon as I got up and changed positions they went away. The real test of true labor is to change what you're doing and see if the contractions continue. In our birthing class we're also taught to look for "emotional signposts" to determine what stage of labor we're in. If I still have a smile on my face, I'm not in active labor. This is actually how our midwives determine if it's time to come in to the hospital. They can tell by the tone in our voice when we call in if we're really in labor or not and how far along we might be.

I will be 37 weeks on Friday which will mark this pregnancy making it to full-term. I'm very exciting about this cutoff since it means the baby could be coming at any time.