The Eclectic Dabbler

November is Prematurity Awareness Month. Did you know that? Today, November 17, it’s Fight for Preemies Day. After one baby born at 32 weeks, we are fighting for this next one! I’m at 24-1/2 weeks now.

My case manager called this afternoon–she is so perfect for me! I need her in my life! She always says, “I’m not telling you this to frighten you–I just want you to be aware.”

And for me, that awareness is exactly what I need.

She called today to follow up on Monday’s ultrasound. She too was perplexed by the cervical length from the ultrasound.

A little background: My initial ultrasound showed a cervical length of 3.4. The next ultrasound: 3.1. We were hoping it would remain around 3 cm, with the weekly progesterone shots I’m taking. But yesterday’s ultrasound showed 3.9, although the tech seemed to second-guess herself several times during the ultrasound, and later told me one thing and then changed her mind, which raised questions for me about the accuracy of the measurement. When I asked her, “Is that typical? To go from 3.4, to 3.1, back up to 3.9?”

She didn’t offer any explanation, she just said, “Oh absolutely! Absolutely it could do that!”

I was about to ask her if she could double-check. But then I realized that when I asked if she could tell me if she was still seeing “girl parts,” she had responded, “Was it a girl last time? . . . Well, then it hasn’t changed.” :-/ So I decided not to bother asking her to re-measure, and just to discuss it with the Ob.

Of course, when she called the high-risk specialist (on the phone), and said, “She’s a 3.9″ (without mentioning my prior measurements), he thought that sounded great.

Monica, my case manager, said that she does see those kind of variations, but typically they are due either to a difference in the way the techs measure or an inaccuracy in measurement.

“Unfortunately,” Monica said, “this raises more questions, than it answers and just leaves you with more anxiety, since you’re still experiencing contractions.” That said, she added, “I do think it’s probably safe to say: it’s likely that you are still a 3, although I doubt you are actually a 3.9, so we are probably not dealing with cervical incompetency. It’s probably more an issue of an irritable uterus. The question now is: How much irritability does your uterus withstand, before it becomes preterm labor?”

She told me that the 17p progesterone is supposed to relax the uterus so it doesn’t contract at all, and there is no way to gauge how many more contractions I might be having at this point, if I were not on the progesterone.

She raised an interesting point. She said with contractions this early in pregnancy, we are not looking for all the traditional labor signs that you would look for at the end of pregnancy. She said if I experience more than four contractions within an hour (and they do not subside with rest and hydration), I need to be on the phone with my Ob. Some women who have delivered babies previously assume, since they’re not in “hard labor” or having difficult or very close contractions, that the baby is alright. That’s not the case. Her point was that the baby weighs about 1 lb., 12 ozs. at this point. I’ve delivered two babies already. She said at this stage of pregnancy, you don’t have to be dilated 10 cm to deliver–this baby could easily come at 4 or 5 cm because of its size. She said if I am dilated at all, even 2-3 cm at week 24, I would be likely hospitalized (unlike with Micah, who was larger when I was at 3 cm, and I was allowed to be home on bedrest until 4 cm).

She said, “I’m going to call you next week before Thanksgiving, and I know you’ll have family in town. But I just want to be that little voice in the back of your mind saying ‘Take it easy. You don’t want to be on bedrest or hospitalized.’”

I needed to hear that perspective. It really didn’t frighten me at all. But the awareness is something I need! And I appreciate that “little voice.” Little Boo, someday, will appreciate that little voice–after she is born healthy at full-term, right?!

That brings me back to Fight for Preemies Day, which is all about awareness!

One of my favorite blogs is The Spors Are Multiplying about Maddie, a 28-weeker who spent 10 weeks in NICU and unfortunately passed away at 17 months due to complications of her prematurity. Her mother is pregnant–due in February–and they are obviously monitoring “Binky’s” pregnancy very closely. Today’s post was about Fight for Preemies Day, written by a mom who through deep grief has learned all too well the need for awareness. . .

Fox News ran a story today about March of Dimes’ work to prevent preterm birth. It’s the story of Joshua Hoffman, who was born four months premature, weighing 1 lb. 11 ozs. His family is the 2010 National Ambassador Family for March of Dimes. Joshua’s mom successfully delivered her second son full-term, with the help of my favorite weekly shot–you guessed it, 17p hydroxyprogesterone! That was encouraging to me as well.

I never ever imagined I would have a preemie–even after two of my best friends–bridesmaids in my wedding–had preemies. It just seems like something that happens to “someone else.” Thankfully, my little 32-weeker (who incidentally was throwing my little decorative pumpkins over the back of the couch tonight and crawling off the couch to go get them and do it again) seems to be completely normal now, free of any long-term developmental problems or needs for surgery or special treatment! We named him “Micah”–which means “Who is like our God?!” We praise Him for His goodness!

So! On this day, take a moment. Be aware. Fight for Preemies.

My littlest daughter is 23 weeks along now. I mentioned to Daniel that, at 23 weeks, babies actually have a 10-20% chance of surviving outside the womb.

Daniel looked a little stunned. “Well, that’s depressing,” he said.

I thought it was kind of amazing–just from the standpoint that, if something happened and she was born, she now actually has a chance of surviving! (Some friends of ours lost a baby at 20 weeks. He was due the day Mara was born, and of course, at 20 weeks there was just no hope for the baby–nothing they could do.)

In addition, our baby’s chances of survival outside the womb increase almost exponentially over the next few weeks.–Those are the statistics that Daniel finds encouraging!

As for Little Boo herself: she must be an optimist.

During the ultrasound, she gave this very clear “thumbs-up,” and our tech captured the delightful moment for us.

I’ve been wanting to post this picture for a couple weeks now and haven’t gotten around to it. You can see the “thumbs-up” on the right, and that’s her foot on the left.

(Have I mentioned that I love baby feet too?!)

I’ll get to see them again on November 16. For now, I just feel them kicking.

My prescription for Progesterone shots (17P) arrived in the mail today, along with a bunch of needles and syringes.

Imagining my husband (who is not in the medical profession for a reason) administering these shots is a little, well, unnerving. Shots don’t bother me too much at the doctor’s office.

You know, with a trained professional.

When I try really hard to “think happy thoughts.”

But just imagine coaching someone the very first time they give a shot, and it’s in your rear end. That will be a new experience–for both of us! Thankfully our insurance company is sending someone to our house to train Daniel on giving the shots.

Oddly enough, I’m actually looking forward to getting the shots, because I’ve already noticed contractions beginning. And I’m only 19 weeks. So yes, bring on the needles!

When I called my insurance case manager today (I’ve been assigned a case manager, since my pregnancy is considered high risk), she said my file at the doctor’s office indicated I would start the 17p shots at week 20.

I was actually disappointed. You mean, I have to wait a week?

My contractions usually come at the end of the day–often around dinnertime, bathtime, or the kids’ bedtime. But I notice them every day now.

Carrying Micah up the stairs, bringing groceries from the car into the house, carrying laundry up from the basement, long walks outside, walking/standing for a long time (for instance, last Saturday’s 6-hour Goodwill/ consignment store shopping trip!). All those things cause me contractions. I’m really not doing anything excessive, just normal housework and child care kind of things. But it is amazing how many activities around the house require the use of your abs. And for some reason, those activities seem to bring on the contractions.

My contractions aren’t regular at all. And like my contractions with Micah, not painful, just tight. My uterus is still so small that they aren’t really even uncomfortable yet.

But it makes me a bit nervous. For Little Boo.

I talked to my Aunt Terrie a couple days ago. (Aunt Terrie knows a thing or two about pregnancy, having delivered eight children of her own and worked as a La Leche League consultant. When I told her I was starting to notice contractions already, she said, “Yessss, it starts earlier and earlier with every one.” Yay. I thought. So I am probably not physically capable of carrying eight children full-term, am I? (What a relief, right, Daniel???) He wants four children. I’m wondering if five would be all that bad. . .

I find it helpful to rest when I’m experiencing contractions. They do go away. And that’s a good sign.

I’m also trying to drink tons of water. (Dehydration often contributes to preterm labor.) I’m trying not to walk too much, or be on my feet too long, & I try to ask for help lifting (despite the fact that I am the do-it-yourself kind of person that hates to ask for help).

All that to say:

Bring on the needles!