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:

First prenatal appointment

We had our first prenatal appointment this morning. We met with one of our midwives, Polli. Before getting pregnant and once we found out we were pregnant we did a lot of research on what we (but mostly I) wanted out of pregnancy and delivery. I read a lot of personal accounts but also research about the effectiveness of midwives vs. obstetricians. Basically, it comes down to the use of interventions during prenatal care and childbirth. Midwives have lower rates of all forms of interventions (cesarean sections, episiotomies, forceps deliveries, etc.). Here's an abstract from a randomized control trial in Canada where low-risk mothers were randomly assigned to be treated by a midwife or an OB/GYN or family doctor. A retrospective study in the US also shows that women under the care of a midwife receive fewer c/s. Women who see midwives are also more satisfied with the care the receive and with their delivery experience as shown in this article. Midwife-assisted births were also studied here in Southern CA with positive results in a longitudinal study of LA County and USC's midwifery program. Although, I've anecdotally heard that UCLA's midwives are much better than USC's. After taking all of this into account we decided a midwife was a better fit for us.

So we're using the UCLA midwife group. I think it's a bit unusual how it's set up but the midwife group sees patients as apart of a midwife-OB/GYN practice. There are 5 midwives and 5 OBs. I'll see all of the midwives over the course of my prenatal care and then whichever midwife is on call when I go into labor will deliver our baby. The midwife we met with today (Polli) told us that they all have different personalities but they really follow the midwifery vision which is that this is a partnership between us and the midwife and we make the decisions together. They are minimally invasive but use technology and interventions when necessary.

So here's the run-down of what happened at the visit:
-Filled out my medical history.
-Met with a nurse to get blood pressure taken, pee in a cup and given a pregnancy book and packet of information.
-Met with Polli for about 20 minutes to go over medical history, determine the due date, explain procedures & prenatal screening/testing and have our questions answered.
-Physical exam (breast exam, overall wellbeing, internal check & swab).
-TB test
-Blood work and another urine test.

Polli gave me a due date of 4/30. So I'm going to say my due date is between 4/25-4/30.

Prenatal testing

We are low-risk since we're both young and healthy and don't have any history of birth defects in our families. Polli recommended that we have two prenatal tests. We'll do an ultrasound at 12 weeks along with blood tests and then we'll do a 2nd ultrasound at 18-22 weeks with some more blood tests. She felt, and we agreed, that these are the only tests that are necessary for low-risk pregnancies. If any of the tests show potential problems then we'll move on to more invasive tests (amniocentesis) if necessary. I'll go back on Oct 16 for the ultrasound and my next visit. After that I'll be seen once a month until close to the end of pregnancy. Polli explained to us the fears some people have about ultrasounds and why this particular one is safer.

Other notables

I will give birth in UCLA Medical Center just like any other delivery with an OB/Gyn. UCLA was recently ranked the #3 hospital in the country by US News and World Report and the #1 hospital in the West. We're confident that we are getting the best care possible especially in the case of an emergency. Their c/s rate is 12%. 50% of their patients do not have epidurals. Intermittent fetal monitoring is ok and I don't have to have an IV so I will be able to move freely during labor. I'm free to eat and drink during labor. The baby will be given to me immediately after birth so it can have immediate skin-to-skin contact (this is probably the most important thing to me for our birth) and can nurse right away. The baby will only be taken away after it's done nursing. Babies room-in with moms, they don't even have a standard separate nursery for babies. I can have an early check-out if I want.

Recommendations
-Start taking an omega-3 supplement. An over-the-counter medication called "Expectalipil" was recommended which is derived from seaweed instead of fish.
-Exercise. Recommended walking, swimming and prenatal yoga.
-Weight gain should be between 25-35 lbs. She reminded me that the less I gain the less I'll have to lose later.
-Call right away with any bleeding, since my blood type is O- and Scott is A+ our baby could have a different Rh factor than I do. I'll need shots at a couple points during pregnancy/delivery but if there's any bleeding during the pregnancy I might need a mini-shot.

That's about it. We will return on October 16th (my mom's birthday) to see the baby for the first time and to meet with the midwife again.