Well, tomorrow marks 29 weeks, but this update is more about what's been happening this week, so I'm titling this post "28 Weeks" for the sake of good record keeping. :)
As you may remember, we have been monitoring the length of my cervix throughout this pregnancy (every four weeks) via ultrasound to see if it is shortening at all. One hyphothesis as to why Burkley may have come early is that perhaps I have a short cervix, so my midwife was wanting to monitor it this time around and see if it shrinks as the baby grows and puts weight on it. I was measured at weeks 13, 17, and 21 and the results showed little to no change in my cervical length.
For those who appreciate a visual image and aren't weirded out by female anatomy, here's a picture. I find a diagram always helpful in understanding medical concepts! See that cervix there? That nice long tube (that will dilate for baby to come out)? My midwife tells me that the average woman's cervix is 4cm long until the end of pregnancy or until it starts to efface during labor. If mine is short, or gradually shortening, then it could be that Burkley's amniotic sac (in the uterus) was so close to the vaginal opening which caused my water prematurely rupture. After telling her that the day my water broke I spent time playing my French Horn and then that night when watching Biggest Loser with the hubby, we were both laughing a lot, she began to think that this hypothesis had even more merit. Any kind of jolting would've ruptured my membranes if my cervix was totally shortened and my sac was right there by the opening.
So, this time around, she suggested we do transvaginal ultrasounds every four weeks to monitor the possible situation. At 21 weeks there had been no signs of change. It was shortening by only a hundredth of a centimeter from month to month, so she said we could phase out these checks and maybe rule this hyphothesis out as reason why I had premature labor with Burkley.
Then, on Christmas Eve, at 27 weeks, I went in for a monthly checkup. All seemed fine, but for some reason she suggested that since it had been six weeks since my last cervical length check via ultrasound, that perhaps we should check it again. I agreed, but in my head I thought to myself that it seemed unnecessary and considered skipping the appointment I had made for the following week. I could just "forget" to go get it checked, right? Even the night before my appointment I was planning on not going. But then, that morning, Burkley and I were out running errands and had a lovely enjoyable time at the library and I decided, "Eh, we're out, let's just stop in. I have no reason to blow off this appointment." So, we went. He was a dream, uncharacteristically patient (for a two year old) and it all went well. These ultrasounds are really quick, but this one seemed to take longer. The technician, when finishing the ultrasound, asked if I minded if she checked the baby's heartbeat. I had never been asked that before at these ultrasounds, so I thought it kind of odd, and although in my gut I wanted to say no, I let her. No big deal. Then she asked me, as I get asked every time, when my next appointment is with my midwife. I told her it was next week and we went on our merry way.
We stopped at Target to pick up some items for lunch and then headed home. When I got home, we unloaded the groceries and I started to cook lunch. Then my phone rang. When I saw that it was my midwife's office, at first I thought it was one of those, "Remember, you have an appointment on...." calls. But then I thought perhaps it was related to my ultrasound. So, I answered. The nurse said, "You had your cervical length ultrasound today, right?" I confirmed. Then she said, "Did the tech tell you that it is shortening?" Um, no. Then she said, "[Your midwife] would like to see you today. Please come in as soon as you can. Oh, and lay down until you can get here." Woah! What!? So, I called my mom to see if she could come over and stay with Burkley while he napped. I finished lunch, got him down, my mom came over, and off I went, back to the midwife's office.
When I got in, my midwife sighed and said she was sorry that I was there, but that we needed to chat. She said that at my last check at 21 weeks, I was at 3.59cm (remember, the "normal" is 4cm), which wasn't too concerning to her. The check that morning indicated that I was at 2.5cm. She said it was not so much the number that concerned her, as she does have some patients who are a 2 or a even a 1 their whole pregnancy with no issue, but the rate at which it was decreasing was what bothered her.
Then I was told where to go from here. I am to be laying down in a horizontal position on my side 4-6 hours a day. When I am up and at 'em, I am to be "taking it easy." She would like me to see the OB/GYN with whom she works so the two of them can collaborate on my care and determine the best course of action for me. She wants to make sure she's recommending the best thing. She also hinted that I should not let this doctor know that we are attempting tandem nursing. ;) She did ask how often Burkley is nursing and since I told her it is only for a minute or two before naptime and bedtime, she was not concerned. I was reminded that sitting does not count as laying down and sleeping at night does not count toward my 4-6 hours. Interestingly, she indicated that there is not sufficient medical, research-based evidence to actually support the role of "bedrest" in preventing preterm labor, but that in her years of experience, she personally feels she has seen it work. She wants me on this part-time bedrest until we reach 32 weeks, which is when baby's brain capillaries are better (or fully) formed, thus preventing the likelihood of baby having a stroke in his or early hours/days if born before that point. She reminded me that I am not in labor, which I suppose I knew, but that we are trying to keep that from happening. If there were signs of labor, then we'd be doing much more to stop baby from coming.
Additionally, I have to stop cleaning houses, which is what I do for extra income. I'm a bit worried about that, but I trust the Lord will provide.
All of that was yesterday. I've now had 24 hours to contemplate it and try this whole bedrest thing out. So far, it's going fine. Remembering that sitting doesn't count has been the hardest thing so far. I hate feeling like I'm slacking on housework as well as not being active with Burkley, but so far it's alright. He's being understanding of my playing from the couch or bed and my hubby has been great about not expecting much from me around the house. :)
I'm curious to hear what the doctor says next week; to see if my regimen changes or stays the same.
Have any of you ever been on bedrest? Any tips or words of wisdom for me?
As you may remember, we have been monitoring the length of my cervix throughout this pregnancy (every four weeks) via ultrasound to see if it is shortening at all. One hyphothesis as to why Burkley may have come early is that perhaps I have a short cervix, so my midwife was wanting to monitor it this time around and see if it shrinks as the baby grows and puts weight on it. I was measured at weeks 13, 17, and 21 and the results showed little to no change in my cervical length.
So, this time around, she suggested we do transvaginal ultrasounds every four weeks to monitor the possible situation. At 21 weeks there had been no signs of change. It was shortening by only a hundredth of a centimeter from month to month, so she said we could phase out these checks and maybe rule this hyphothesis out as reason why I had premature labor with Burkley.
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| Christmas Eve, 27 Weeks |
We stopped at Target to pick up some items for lunch and then headed home. When I got home, we unloaded the groceries and I started to cook lunch. Then my phone rang. When I saw that it was my midwife's office, at first I thought it was one of those, "Remember, you have an appointment on...." calls. But then I thought perhaps it was related to my ultrasound. So, I answered. The nurse said, "You had your cervical length ultrasound today, right?" I confirmed. Then she said, "Did the tech tell you that it is shortening?" Um, no. Then she said, "[Your midwife] would like to see you today. Please come in as soon as you can. Oh, and lay down until you can get here." Woah! What!? So, I called my mom to see if she could come over and stay with Burkley while he napped. I finished lunch, got him down, my mom came over, and off I went, back to the midwife's office.
When I got in, my midwife sighed and said she was sorry that I was there, but that we needed to chat. She said that at my last check at 21 weeks, I was at 3.59cm (remember, the "normal" is 4cm), which wasn't too concerning to her. The check that morning indicated that I was at 2.5cm. She said it was not so much the number that concerned her, as she does have some patients who are a 2 or a even a 1 their whole pregnancy with no issue, but the rate at which it was decreasing was what bothered her.
Then I was told where to go from here. I am to be laying down in a horizontal position on my side 4-6 hours a day. When I am up and at 'em, I am to be "taking it easy." She would like me to see the OB/GYN with whom she works so the two of them can collaborate on my care and determine the best course of action for me. She wants to make sure she's recommending the best thing. She also hinted that I should not let this doctor know that we are attempting tandem nursing. ;) She did ask how often Burkley is nursing and since I told her it is only for a minute or two before naptime and bedtime, she was not concerned. I was reminded that sitting does not count as laying down and sleeping at night does not count toward my 4-6 hours. Interestingly, she indicated that there is not sufficient medical, research-based evidence to actually support the role of "bedrest" in preventing preterm labor, but that in her years of experience, she personally feels she has seen it work. She wants me on this part-time bedrest until we reach 32 weeks, which is when baby's brain capillaries are better (or fully) formed, thus preventing the likelihood of baby having a stroke in his or early hours/days if born before that point. She reminded me that I am not in labor, which I suppose I knew, but that we are trying to keep that from happening. If there were signs of labor, then we'd be doing much more to stop baby from coming.
Additionally, I have to stop cleaning houses, which is what I do for extra income. I'm a bit worried about that, but I trust the Lord will provide.
All of that was yesterday. I've now had 24 hours to contemplate it and try this whole bedrest thing out. So far, it's going fine. Remembering that sitting doesn't count has been the hardest thing so far. I hate feeling like I'm slacking on housework as well as not being active with Burkley, but so far it's alright. He's being understanding of my playing from the couch or bed and my hubby has been great about not expecting much from me around the house. :)
I'm curious to hear what the doctor says next week; to see if my regimen changes or stays the same.
Have any of you ever been on bedrest? Any tips or words of wisdom for me?
Even knowing the general story, I enjoyed reading the details how they happened.
ReplyDeleteI've never been on bedrest, but I have been on pelvic rest.
So... at 32 weeks, do you think you'll be so stir crazy that you HAVE to do something? Or do you think you'll be willing to stay on some bed rest to still try to prolong the pregnancy as long as possible? Are they considering a cerclage if the problem continues? How soon will they check you again?
Jorje, I wonder the same thing about whether or not I will be advised and/or choose to just continue the bedrest beyond 32 weeks until Baby C arrives. The plan is to get checked again in three weeks, but we'll see if the OB/GYN has a different opinion. Cerclage has not been mentioned yet, I'm hoping to avoid that route as it kind of creeps me out! :)
DeleteI was on pelvic rest for my ENTIRE (from positive ultrasound until 6weeks post partum) pregnancy. I think that cerclage usually happens before now if it is going to happen. Best wishes for safely remaining pregnant to let the baby cook a bit more.
ReplyDelete