Actually, the technical term is “High Risk,” as in this mom just joined the honorable ranks of having a high risk pregnancy. It’s a title I have no interest in earning.
I am the fourth of eight children, so I have spent a fair share on my life around pregnant women, and women sharing their epic tales of bringing these little miracles into the world. For my mother and the majority of her family (a large sample size, encompassing some thirty-odd grandchildren), babies came late and babies were hefty. “Bos babies” we called them – usually in the 9-10 pound range. And generally healthy, which we always acknowledged as a blessing from the Lord.
My pregnancy began very normal and very healthy. Baby has always been measuring well, and apart from a small concern over dilated kidneys, everything was going swimmingly. I felt amazing (still do), and wondered what all the fuss was about over how awful pregnancy can be. I never got sick my whole pregnancy, and sleep was harder for my husband than for me.
Given how things were going, and my family history, I fully expected a huge, late baby, just like my mom had. I was just shy of 10 pounds at birth, and my husband was just over 8. My biggest concern was whether or not the doctors would let me go beyond 41 weeks and wait for spontaneous labor. I registered for larger clothes, assuming the baby would never even squeeze in newborn clothes and would fly through to 3-month outfits. I completely ignored my due date and just assumed I would go well beyond, attempting to prepare myself for that “home stretch” I had always been warned about.
For that reason, when 31 weeks rolled around, I presumed I had ten weeks left – at least. I saved all the baby prepping for the very end, assuming I would have tons of time on my hands waiting around and would need something to occupy myself. I had no baby stuff, no baby furniture, the car isn’t ready, I’ve taken no classes, and the bag isn’t packed. I had time, and I was pacing myself. My baby shower was anticipated to be late in August, three weeks before my due date – later than usual, but August was a busy time for my family and it was most convenient.
Thursday, July 13, all that changed dramatically.
By the grace of God alone, we happened to schedule a Level II ultrasound for July 13. As I mentioned, the baby’s kidneys had been very *slightly* dilated consistently since our 19-week anatomy scan. At that time, the doctor said that dilation could have been a marker for down’s syndrome, but thought it was unlikely. After prayer and consideration, we decided the test for down’s syndrome was too risky, and it wouldn’t change anything for us. We decided to put off any special testing and just monitor it.
We had gotten a number of follow-up ultrasounds, and the dilation remained consistent. The doctor recommended at that point it was more likely to be a slight blockage, and suggested we simply take a closer to look to determine if we should consult with a pediatric urologist about care after birth. Worst case (and least likely) scenario, there was some kind of blockage and the baby would have to have surgery to relieve it.
At that point, we felt like we were not acting out of fear, and rather felt clear-headed going in to get the Level II ultrasound. We felt that it would be wise to meet the specialist now, so we could see if we are comfortable with him or her in the event the baby needed treatment.
The truth is, God had been guiding us and leading us ever since the 19 week scan to get to this appointment, because what we learned there was a total coincidence and we would not have found it if we got the Level II after the initial 19 week scan, or if we had taken any different course of action.
On July 13, we sat down and the doctor took all her measurements: kidneys, heart, spine, umbilical chord, blood flow, amniotic fluid levels, head, torso, femur, arms – everything. We came into her office and sat down for her report.
The good news is, the kidneys are very very slightly dilated, and it is something she is not worried about. It is a very common occurrence, and will simply be checked on again once the baby is born; they usually clear themselves up. She didn’t even find it necessary to refer to us a specialist because she found the possibility of requiring surgery was so remote. We were relieved, and it was what we expected. We we still relieved.
But then the meeting wasn’t over. She informed us the baby was measuring smaller than she would like. She double-checked that I had my due date correct: September 12. She informed us that the head, femur, and torso size were all measuring in the 5th percentile for its gestational age (I was 31 weeks, 2 days; baby was measuring at about 29 weeks, 4 days). She advised us that any time the baby measures less than the 10th percentile, that’s a red flag. And this is a problem.
It could indicate the baby is not getting sufficient nutrients from the placenta, so the baby needs to be watched very closely from here on out because a placenta problem increases the risk of stillbirth. Her recommendation is daily fetal kick monitoring, and twice-weekly nonstress tests, along with weekly ultrasounds.
Needless to say, we were overwhelmed.
I had my regular doctor’s appointment scheduled for the very next afternoon, and wanted to make sure she got the report in time to discuss this all with me then. When I went in to meet with her, I was very much hoping for advise along the lines of “This is a precaution/ it’s very common/we could be wrong/we are just being careful.” That is not what happened.
She told me my baby has been diagnosed with symmetrical intrauterine growth restriction: in layman’s terms, the baby is not growing well and they don’t know why. (My cousin Hannah – RN extraordinaire – says, “You have a crappy placenta and a small baby.”) It’s very rare and very serious.
I asked my questions and got my answers:
- Why is this happening? What can I do to help? Answer: We don’t know and there is nothing you can do because you didn’t do anything wrong. You eat right, moderately exercise, don’t smoke or do drugs. Not even bedrest or changing your diet would do anything. You have gained 30 pounds already this pregnancy – you are not malnourished! It’s just not getting where it needs to go.
- Could you just have my due date wrong? Answer: I’m confident with the due date. The first two measurements at 10 weeks and 19 weeks are the most accurate calculation of that due date, and the baby was measuring within just a few days of what we set then based on your last cycle. The due date is not off, and certainly not by this much. Similarly, although there is always a margin of error in ultrasounds, a margin this significant is not the culprit. There is something going on.
- Are we just being careful here, or do I need to make sure the nursery is ready early? Answer: You need to make sure the nursery is ready early. And you should move up that baby shower.
That afternoon, we decided to start steroid injections to encourage lung development in the event I would have to deliver early. I walked across the street to the hospital and monitored the baby with a nonstress test and took my first shot. The next shot was administered 24 hours later. I got my aggressive schedule of appointments, scheduled all the way through September 8, but my being pregnant still on September 8 was a long shot at best.
In a matter of 24 hours, my whole life had gotten turned upside-down. I hardly knew how to feel, but I felt everything. I still do.
I went from fully expecting a late, fat baby to hoping I get a live baby. The doctor set a target date for me to keep the baby inside until I can hit 37 weeks – August 22. The first milestone before that is 34 weeks – the date at which I can still deliver at my local hospital instead of UCONN. But even before that, every day, and every hour, the baby is inside, presumably growing but certainly moving – is a miracle and I am grateful for every one. Every kick, I tell the baby it’s doing a great job and encourage it. I have no idea if this is sane or not but it’s all I have.
In a matter of a couple of days, my family has already come together with helping hands to prepare for this baby which apparently could make an appearance at any time. My mother and sister-in-law – a new mother herself – cleaned and prepared the dresser for the baby and gathered up the smallest clothes they have (my niece Luciana – a little miracle, too – has already outgrown some things!). My father and brother worked on my new car to get it ready. My other sisters took me out to dinner, and then went and bought newborn clothes for our little miracle. I had nothing small enough for an early, small baby.
My boss has also been insanely supportive. Word-for-word his email to me after I gave him latest update was “You and the baby come first, no exceptions.” I have friends and family praying for us and offering us any support we need. Can God bless us anymore?
My goals at this point are to focus on gratitude, balance, and taking things one day at a time. Every day the baby is in there, we are doing better. I am two days shy of 32 weeks. We are already SO much farther than SO many premature babies who end up doing SO well. We live in an area with some of the best medical facilities in the world, and in a time when babies born well before this point are brought up healthy and well. We have amazing doctors in whom I have great confidence; the OB who discovered the problem and my regular OB were calling and texting each other all day to make a plan for me and discuss my test results. It is very reassuring to have a team on my side.
Then there is the miracle and God’s timing in all of this, and the fact we discovered it at all. Normally, we would not have had a growth ultrasound at this point. The only reason we were there that day is because of what turned out to be an inconsequential kidney question, which we did not address earlier. If we hadn’t learned about this problem now, we would not have nearly as many options as we do at this point and who knows what emergencies we would find ourselves in. God has already been guiding us and leading us to this place, and he is still in control now. We get to check the baby all the time, and get to hopefully see problems before they get out of hand.
The other good news is that I am perfectly healthy. I have no signs of pre-eclampsia (something that could accompany or cause IUGR), and no diabetes. There is no immediate risk to me, and that means time is on our side. Until the baby starts showing signs of distress, or the growth drops off, the baby is safe in there and I am in no danger. That is fantastic.
I woke up at 3:00 am this morning and couldn’t sleep until after 4:30. I wait to feel every kick and every squirm. I had heartburn and was grateful for it: hopefully it means the baby is growing enough to interfere with my digestion! I am probably one of the few pregnant women who wishes she had more stretch marks, and longs for the scale to rise. The irony is, whenever I told people my September due date, they would always sigh and say, “Oh you have to make it through the SUMMER! That’s rough.” Now, I wish I had it rough. I am completely serious. This pregnancy has been so easy on me and I am so small; I am not swollen or uncomfortable. Other than the anxiety this is causing me, sleep is not a problem at all. At first I thought everyone was just being very negative and it bothered me; now I find myself hoping they are right.
It is very strange what a few hours and a few doctors appointments do to your perspective.
The last piece of my mental strategy is balance. It is very easy to go to extremes with a “high risk” label and news such as this. On the one hand, I could be cavalier and just deny there is anything to be worried about. But every medical professional I have consulted with advises me I am not going to carry to m, and the steps we are taking are responsible and reasonable and the best things to do. I don’t want to take the shots, turn my house and my job upside down to try to get ready for this baby early, and spend hours upon hours in doctors appointments. I don’t want an early induction or c-section. I wanted a totally different situation, but that will not be best for the baby and there are reasonable things to do in response to this news.
On the other hand, I could become obsessed. I find myself already shutting down the search browsers to hunt for more information. I cannot dwell. It does no good and I need balance. It is no good for my marriage and it is no good for my health. I want to maintain – for now – as much normalcy as possible. I asked Massimo that we not give up the other hobbies, appointments, and events we have already scheduled, out of a hyper-focus on the “what if” in our heads all the time. We are going to go to work Monday morning, and leave in the evening. He is at a hunting course today to work towards getting certification for his first bow hunting season this fall. He finished his guitar Friday. I am going to plan on going to my friend’s bridal shower next weekend. I am going to make grocery shopping lists and go on dates and try to maintain my sanity as long as I can. The unknown is the hardest part, but clearing my schedule won’t change that.
At this point, I am emotional and worried. But trying to stick with my plan: gratitude, balance, taking things step by step. I appreciate prayers, and offering this little one to God is all I have. The more I consider the miracles of his timing, and his creation inside me, the more my heart is overwhelmed by his mercy. I am mostly telling this story to ask for prayer, and to explain if I seem out of it. Also, to explain why I might suddenly drop off the face of the planet. It is not personal, and the network of prayer and love the Internet provides will be greatly appreciated every step of this journey.
Keep Baby Barbi in prayer. Thank you.