It’s been a month since my last post/pregnancy update, and things around us are rapidly changing with Covid-19. I hope you are all doing well and are able to social distance and take care of yourselves and your families.
This is certainly a unique time to be going through a pregnancy. I’m going to talk first about what is going on with the pregnancy as if they were normal times (for the most part), and then I’ll share with you some thoughts and concerns related to birthing a baby during a pandemic. This is over 2,500 words. I can’t keep it brief–read it if you’re interested, if not, that’s okay with us, too.
Week 31 Pregnancy Updates
I had my most recent appointment with the OBGYN on Tuesday. Originally, I was looking forward to the fact that this appointment was scheduled during Spring Break so that Levee and Blake could come with me and see the ultrasound. Levee is very fond of hearing the heartbeat and talking with the ultrasound tech about all the different aspects of the baby’s anatomy. And I feel an ultrasound is a great way to connect both Levee and Blake as a family with this new human who is currently becoming a part of our family, since from the outside it must seem like this largely abstract concept/blob that makes my tummy wiggle when it hears them talking.
With everything going on, however, and the fact that Levee gets easily ill and Blake does right now, too (he had a kidney infection, then the flu for 3 weeks, and is now recovering from shingles) we made the decision that it would be best for me to go to the appointment alone to minimize our exposure as a family and practice social distancing to the best of our ability while still receiving the medical care we need. Upon arriving at the office, I quickly realized we had made the right decision. Signs were posted on the outer doors to only bring at most 1 support person with you, and no one under the age of 12 is to be allowed. I was checked in at a new small desk first asking about any recent travel and questions about my health. Then I was allowed to check in, but in a bit longer line than usual, with everything at the desk being sanitized between patients. They also are doing wipe-downs of the waiting room every 15 minutes. I stood by the windows, which is what I often do, to look outside and because standing feels better on my back than sitting.
This was an important doctor’s appointment to again check in on baby’s growth rate. If you recall from my last post, baby’s growth rate was great at first, dropped off in second trimester, went up again, and then stabilized at a low but acceptable rate (around 18th percentile). I currently go to the OBGYN every two weeks, as that is her standard procedure for someone in their third trimester. Usually these appointments entail blood pressure check (mine has been “perfect”), weight check (I’m on a quite slow gain but healthy), and urine sample test (for proteins, sugars, blood, etc. in urine–haven’t had a bad test yet). After the leveling out of the growth rate, the doctor still wanted a check-in ultrasound in 4 weeks.
That appointment was yesterday–and even though when I was in with the ultrasound tech things seemed to be going well, the OBGYN did not interpret the numbers that way. Baby is now only growing in the 3rd percentile, which is not a great place to be. Numbers are compared not only against a global bell curve, but also against themselves over the course of the pregnancy. The numbers look almost okay on the normal bell curve, but look very troublesome compared to themselves. Things could still be fine, but it is definitely something that needs to be monitored closely. Baby is still gaining weekly, and measurements of the baby’s body parts look to be growing at a comparable rate to one another and the body as a whole. We had some weirdness in these numbers earlier in the pregnancy between legs/arms/torso that might have required genetic testing should that trend have continued.
In the actual ultrasound itself, the baby was sleeping, for once. Usually baby is moving around a ton and kicking hard, which has caused me to have to have extra ultrasounds a couple of times in order to get proper scans of the heart and other organs. Organs still looked good at this ultrasound, and all was much easier observed with a resting/sleeping babe for the first time. Baby is estimated to weight about 3 lb. 3 oz. right now and is expected to double in weight by birth. Mostly what babies are working on from 31 weeks on is gaining weight–most everything else is fully formed. They are adding fat and brain connections.
Blake and I are hopeful right now because what else is helpful but to be hopeful? We also went through a similar experience with Levee. You can read a bit about that, here: Week 37: The print nugget is funsize. At that point in my last pregnancy, Levee was under 10th percentile, and I was going to the OBGYN’s office twice a week for check-ins. Levee’s birth proved difficult and resulted in an unplanned c-section on our 3rd day at the hospital. His placenta was calcified, and my cervix never fully dilated. I wrote some about this experience in two recent blog posts, Pregnancy Piss and Vinegar and More Piss, Less Vinegar. We have a lot of respect for our OBGYN and trust her to help us through this process. She did an excellent job of helping us through our originally very natural, chemical and pain-med-free, birth plan, which unfortunately evolved through many other stages over several days (while carefully monitoring Levee’s well-being) before we had to make the tough decision to go with c-section.
I now will be going in weekly for appointments to keep an eye on growth and make sure baby is alive. I will do NSTs, non-stress tests, every other week with the alternate weeks being ultrasounds with follow-up appointments. I have scheduled about 3 weeks of these in advance but wasn’t able to schedule further with the office right now since our OBGYN may need to add in even more check-ins depending on how things evolve.
I’m grateful that this baby is very active with a regular schedule of activity. I can tell that they are alive and well, and we have a relationship forming. This gives me peace of mind on the daily.
Giving Birth During a Pandemic
During my talk with the OBGYN this last visit, she did say something I was prepared to hear, as I have heard from doctor friends and in my reading news articles online that this is happening around the country: I may not be able to come in as often/continue regularly scheduled appointments as normal should the Covid-19 situation evolve the way it is expected to in order to keep from overwhelming the office. The office I visit does have two wings, so their contingency plan at first will be to have 1 side dedicated to those ill with Covid-19/Flu-like symptoms and 1 side dedicated to other patients. This isn’t perfect, as of course I’m sure you have all read that one may be infected with Covid-19 for quite some time (sometimes the whole time) before exhibiting symptoms, yet it can still be transmitted to others. I understood and told her I trusted whatever decisions they needed to make in that regard.
She did assure me that OB patients are of a very high priority and will remain that way, I assume particularly at my point in pregnancy (only 60 days to go!) and with the growth rate issues we are experiencing that require careful monitoring for best outcomes.
As I mentioned in some recent Instagram/Facebook stories and a recent post, I am concerned about the fact that I am scheduled to head to the hospital around the time that the virus cases may be peaking in the USA (if we practice decent social distancing, that is). Many of you had very kind words and thoughts in response to this, and I very much appreciate them. I don’t feel I have a lot of options/alternatives to going to the hospital on or before May 17th, but I did discuss this topic with my OBGYN at this appointment.
Even last time around, I explored options for home birth and working with a midwife. These were pretty well eliminated as options by the slowed growth rate, fact that labor did not begin by due date AND baby was small (and, statistically, small babies not induced on or before due date are more likely to die) and, therefore, it being important for me to be induced and be within arms reach of medical/surgical interventions if my natural labor plan did not work out. As you’ve maybe read, it didn’t, though we gave it our darnedest for several days, and c-section saved Levee’s life. With my insurance, I might have been able to work with a state certified midwife for this pregnancy, but this may not be an option since I had complications with my last pregnancy.
I asked my doctor yesterday if I should contact one just in case the hospitals are overwhelmed as a back-up plan, and she did say it might not be a bad idea. I will of course pay out of pocket if forced to (would have to be over time in installments, that’s for sure, as I’ve already pre-paid for hospital birth in installments and who knows if I’d get reimbursed or what and if anything would be covered. Our individual and family deductibles are shamefully high). It is more important that my baby and I survive this birth, so even if my insurance doesn’t cover it, it is likely a good idea for me to have a backup plan for the hospital and just do the best I can in case of lack of access to the hospital. I will be looking into this more over the course of this week. I’d already pre-registered for the hospital birth before Covid-19 was being taken seriously in this country, and my OBGYN was hopeful, as are we, that there will still be hospital space reserved for births. I think none of us really know what is going to happen, however, and the situation is clearly quickly escalating in this country.
Even if I am able to be admitted to the hospital to give birth, I am also concerned about my own health and safety in the hospital, my baby’s health and safety, and that of my partner and family. My Moms are planning on coming here from Georgia for the birth, to be present to meet the baby, and also to watch Levee while we are at the hospital and help out at home afterwards. They came for Levee’s birth, and it was a big help. One is almost 70, the other in her 60s and with some additional health conditions. It may not be a great idea for them to travel at all or come here given those facts. They were also supposed to come visit in 2 weeks to hang out and also help with Levee while Blake was in Puerto Rico for the Southern Graphics Council Conference International (SGCI). SGCI has now been postponed, as has Blake’s trip, so I spoke with them and due to that, my grandmother’s current health, and the current Covid-19 situation, they are staying at home. We may have to make a similar decision come May.
If that’s the case, I could be headed to the hospital alone to give birth. I don’t want Levee to be there, that’s for sure. Blake has also had a low immune system in general, so it might not be great for him to be in a hospital environment. As I told my OBGYN, I am at peace with that, but obviously it’s not ideal. I don’t want to be alone. I would want to call Blake every time a doctor or nurse came in the room to tell me something important so he could help me talk to them and remember it. I have a horrible memory, and it is made worse when I’m focusing majorly on birthing a baby. Blake had to help me through all of my memories of my previous birth, because I only remember the strangest details and very little of the big things.
We have some friends here we could talk to about popping in to watch Levee a day or so, and I am grateful to them. I also don’t want to put them at risk if there is any reason Levee or we shouldn’t be around others, so I’d rather birth alone than put my friends at risk. My OBGYN said they could arrange to pick me up if for some reason I can’t be driven/drive to the hospital. We do live just across the park from the hospital, so that is a great benefit being so close. At the worst, Blake and Levee could drive me over and drop me at the door. I’m good at bucking up during things like this and am confident I could muscle through it. I wouldn’t like Blake to miss the birth of his second child, and I of course want him there with me more than anyone else in the world.
I asked my doctor if I go into labor naturally, could I labor at home a while. She said she had to reserve judgement on that right now. The loose plan at the moment is that if I don’t go into labor by my due date, May 17th, I will need to be induced. Last time I chose a manual ballon-catheter induction (over chemical induction), and that worked well for me. I would choose this again if necessary and possible. The plan as of right now is to still attempt a VBAC.
So I am hoping that the baby continues to grow well–and it could just be a small baby, as my OBGYN said this was a possibility, and that everything could be fine but these numbers just mean we need to monitor and be a lot more cautious moving forward. I am hoping that the hospitals don’t get overwhelmed–for everyone’s sake. I am hopeful Blake can be with me during birth, and of course that everything will go well. This paragraph is a meditation on my positive thinking, and I am doing okay with that. I am not, as of now, freaking out.
Coming Soon and General Updates…
In the last post we shared an Amazon registry with a handful of things we’ll need for the baby. We’ll see if baby prep stuff is seen as essential right now. Glad we have a couple months before we need most of these things. We mostly put the registry together so that we could take advantage of the 10% “completion discount”, and have gone ahead and bought the car seat, but if folks are interested in investing in Al A. Poopy you can go check the wish list out. Having you all following our growing family with interest is plenty of reward in and of itself!
We have plans to share some thoughts on the aftermath of Covid-19 and Education based on our experiences of disasters in the past. There are so many great resources out there right now for moving art courses online–we are thinking, too, about transitioning back to the classroom and best practices for working with other humans after an ordeal like this. We will write and share these thoughts in the coming months here in a post.
Right now, we are on Spring Break, trying to enjoy some much needed rest and family time, work in the yard, read, etc. We are also working on educational contingency plans and moving our art courses online. Southeast Missouri State has only announced one week of distance learning after Spring Break so far. I cannot speculate further on what will occur, but looking at national trends and my own desires, I am planning for longer. So this is part of our Spring “Break” as well. I run a small letterpress/printmaking business for the university, and am now looking at doing all of the work of that largely alone without student assistance. Some jobs have been delayed, but some deadlines are still on. I will be getting back to work on those next week.