Yesterday, we had our final grand check-up before the doctors were to decide, when they want to schedule induction of delivery. In Denmark this is normal practice, though there are significant regional differences, with some hospitals hoping for natural delivery commencement and others playing it safe with induction weeks before term. We belong to one of the latter kind. What started out as a great day was turned into utter feeling of frustration and tears :-(Our day started at the midwife for a CTG on the baby and a blood pressure check on me. The little one still has a perfectly normal heart rate and activity level, and my BP was just as stable as it as been all way through - 110/73. Next up was the ultrasound weight scan, which again showed that Junior is still following her own growth curve with average tummy and femur measures, but a slightly smaller head. Her weight was estimated at 2,386 grams, which is on the lower normal side at 36 weeks - and which will leave her at just about 3,000 grams at the time when they want to induce delivery.Now, how can you not be happy and totally in love with this little one?
Junior at 36 + 2, 260712
At 3:30 pm the phone rang, and I was told that they'd decided to go ahead with their 38 + 0 recommendation. I argued a bit with the doctor on the phone, and while she said that I could of course reject that decision, then she made sure to play on my feelings, making me feel like a bad parent/patient if I did not follow their recommendations. Both before and after that phone call yesterday I was an emotional mess because of course I don't want to risk complications for me or the baby, but I also have this strong feeling of 38 + 0 being too early for both of us. It's hard for me to explain, but it just does not feel right, especially with the baby's current size and growth.
Now that I've slept on it, I think that I'll ask the midwife at the appointment next week whether if I show up for the 38 + 0 appointment, I'll be able to reject their pills if the baby and I are still doing fine and there are no signs of any of us being ready for starting the induction process at that time, or if I have turn the appointment down in advance. In the end of course, I hope that the midwife will be able to come up with a recommendation that is more on my side of things, as I can only imagine that things will be easier if both me an the baby appear more ready for delivery to be induced.....
While you sometimes - especially when you're a kid or teenager - feel that you could do without their presence or well-meaning advice, other times it's the smallest things that makes you remember why and just how much you love your family. A couple of weeks ago was my sister's birthday and we'd been invited to a Sunday morning brunch. Our parents came over on Saturday and we all had dinner together at Jimmi's and my place, so we had already sorted her presents at that time. I say this, because it turned out that what Jimmi and I thought would be a birthday brunch for my sister, was actually a baby shower for us that my sister had arranged with both our families and a couple of our friends! Her reason: In her own experience, it had been incredibly hard to constantly have people dropping by with presents in the weeks after their daughter was born, so she hoped that by letting our families provide us with their presents now, we'd get a calmer first few weeks and be able to decide when we're up for visits :-) Have I mentioned how much I love my sister?
Today I'm 35 weeks pregnant, which means that after my appointment next week, the medical team will meet up to schedule when they think delivery should be induced. We've discussed this with our midwife on a few occasions, and while she's seems open-minded and supportive of our wish to not force on delivery if it's not medically necessary, she also took the time to explain to us the likely reason that the OB had seemed rather dismissive, when we asked about this possibility last week. It seems like the "induction at 38+0-rule" is based primarily on experience - and since it almost always work well then they are hesitant to make any changes because, if something should go wrong it may be difficult for them to determine if what went wrong would have also gone wrong had the induction taken place at 38+0 and not later. I fully understand that argument, and I may also feel like just getting things over with at that point, but as both junior and I seem to be doing perfectly well currently, and the little one is actually estimated to be on the lower side weight-wise, I do have some difficulty coping with the fact that she may not be allowed to mature more than 3 weeks more inside of me.
It may just be the fact that in this case I may not have much to say about the course of actions that makes me feel uneasy about it. I don't know, it just seems strange to me that when there are absolutely no indications of diabetes-related complications for junior or me that they'll still insist on inducing delivery no later than 2 weeks before the official due date. The little one is still growing steadily, but their continuous measurements have kept the medical team very attentive because apparently the little one's head measures slightly smaller than what the median measures are, while the tummy and femur measures are always spot on. Because every thing else seems to be perfectly normal (heart rate and activity level), I find it a bit difficult to be really worried about this - after all we don't know if this is just genetic variation, because none of us were ever measured to this extend and unless something seems completely off, no one measures a newborns head anyway.
Only time will tell, and we can almost start the count down.....
"Diabetics tend to get big babies" - a very common line among medical professionals. And sure, our babies may be building up more body weight if our glucose levels are too high. After all, insulin is a hormone with anabolic effects and as soon as our little ones start producing their own, they'll just produce more if the blood running from our system into theirs is too sweet.
Still, I think that there are other factors contributing to a baby's weight, regardless whether the mom is a PWD or not. Not least the genetic pool.
I'm now 33 weeks along and have switched from biweekly to weekly check-ups at the hospital. Last week was a full day (well technically only half a day) of midwife (CTG), ultrasound, doctors (OB and endo are fortunately sitting at the same table at every appointment), pump nurse, eye photos and blood tests. Since the beginning of May, the ultrasound appointments have been dedicated to measuring the baby's weight and growth. All three of those appointments so far have shown steady growth, with tummy and femur measures right in the middle of their standard curve, but with a slightly smaller head, resulting in an overall lower weight estimate for our baby (10-20% below the center of the curve, but still within the "normal" range). Last week, the midwife had estimated the baby's weight to be around 1,600 g and the subsequent ultrasound came back at 1,571 g. This had the OB a bit concerned - even though the little one is still following her own growth curve - so she ordered another ultrasound before the next scheduled one, "just to make sure".
At today's CTG-appointment, the midwife estimated the baby's weight to 1,800 g. Next week will then be another ultrasound to measure it, but while I'm not too worried about the baby not growing well, I obviously cannot just forget the OB's worries about it. I asked around in a forum of pregnant and mommy PWD's, and was comforted by the fact that far from all had had big babies. Also, the fact that my now 6 months old niece was also estimated to be a bit too small, but came out at 52 cm and around 3,500 g at 41 weeks comforts me, as it makes me think that maybe it's just part of my genetic makeup (both my sister and I had similar lengths and weights, and none of us were born "on time", but a bit after our mom's due dates). Or maybe it's just because the little one is so active? ;-)
Junior at 36 + 2, 260712
