Baby #2: weeks 27-28
I went into our 27-week ultrasound incredibly hopeful and confident. I came away from the appointment feeling the exact opposite.
While we are so so lucky to celebrate a healthy baby (baby’s brain cyst has gone away!), I was so incredibly shook up and terrified by the news that the placenta is still blocking baby’s exit. Snippets from our terrible terrible meeting with an OB (not my primary OB) that I refuse to see again: complete placenta previa. At 27 weeks. C-section. Early delivery. Possibility of massive, life-threatening hemorrhage at any moment. Steroid shots to help premature baby’s lungs. Pelvic rest, no travel, future bed rest & hospitalization. Life-threatening hemorrhage at. any. moment.
You get crappy iphone photos of ultrasound pics in this blog post… classy! If you squint real hard, you can see baby’s foot.
I went into a massive slump. Crying, stress, general unhappiness, freaking out, constant adrenaline running. I began reading everything I could find on placenta previa. Most of the mainstream internet sites are full of scary stories. The scientific literature is much less daunting, which is strange given that it tends to be full of jargon. In most situations, I’d say that scientific literature is always the more difficult read because it’s audience is meant to be specialists and practitioners, but this time I was finding comfort in statistics, and glad to avoid personal stories or “what to expect” guidelines.
This one shows baby’s profile. Just go with it, it’s not like ultrasound pics are super-clear anyways. 🙂
After reading as much as I possibly could, I had a phone conversation with my OB, and it went much much better. Whereas the first OB was completely unable to provide ANY stats on my chances of this clearing, of the percent of women who have massive hemorrhage or are asked to go on bedrest/be hospitalized, my OB was able to provide me with many (comforting!) numbers. Whereas the first OB seemed intent on scare tactics and worst-case scenarios (seemingly in one of those “I’m a doctor, do exactly as I say and don’t question any of it” tones that I don’t respond well to – because I am the annoying questioning patient), my OB was upfront in acknowledging the potential super-serious life-threatening risks, but she was also quick to remind that the majority of cases resolve without experiencing such risks. She was great at emphasizing that I need to be aware of this condition, but that stressing out about it wasn’t going to be helpful.
28 weeks. My belly button is starting to poke out in super-creepy ways.
Based on our conversation, this still may have a 51% chance of resolving itself before delivery. As many as 50% of women will remain asymptomatic (no bleeding!) during the entire pregnancy. Most bleeds are small/non-life-threatening initially, but can be followed with more serious, heavier bleeding. She said that it’s rare (but still possible) that the initial bleed would be massive, but to take any signs of bleeding seriously. Bedrest would only be suggested after 1-2 bleeding episodes, dependent on severity, and hospitalization would likely not be necessary. The next steps are: an appointment at 29 weeks in which we’d discuss scheduling a c-section for 35-36 weeks (recently experts at an ACOG committee meeting suggest 36-37 weeks may be more appropriate, so I’m hoping to buy a little more time for baby’s growth if possible. see: annoying questioning patient comment above), and another ultrasound will be scheduled sometime in July to check whether the placenta has moved to a better spot.
I’d love it if you could send prayers/good vibes/etc for this to fully resolve before my next ultrasound.
(Also, if you’re finding this because you also have placenta previa, this blog has a good collection of abstracts from relevant scientific papers that I found pretty informative. It’s dated a little – 2 years – but there doesn’t seem to be a ton of scientific advancement in this field since then. Science moves slowly.)
I am now mentally preparing myself for c-section, but clinging to the hope that this will resolve and I’ll be allowed to try to carry the baby to at least 40 weeks and have a normal delivery. I’ve been studying c-section options, making drafts of birth plans (yes! even in c-sections there are choices! see: annoying questioning patient comment above), praying like crazy that my c-section preparations won’t be necessary, and clinging to another important discovery from the ultrasound: our baby has hair! Yep, it sounds a little silly to be excited about baby hair, but these few tiny white lines on the ultrasound screen are serving as an important reminder that in just a few months, the stressors we’re facing now will fade away and there will be a sweet, hairy babe in our arms.
(Note that this placenta previa complication does come with higher rates of mama and baby mortality, a fact that I am desperately trying to ignore.)
Thank God this one loves the baby so much. When questioning to myself whether this risk of her losing her mama way too early is worth it, her love for “the baby in mama’s tum” makes me think the answer may be “yes”.
C-sections can’t possibly be the end of the world, given that many women are willing to repeat the c-section experience to have children. It’s just so very hard to let go of what I was planning on, what I had been expecting — another normal, drug-free, complication-free delivery. I have very real concerns about the baby being taken from me at 35 weeks because of increased risk of blood/respiratory complications for baby and a possible NICU stay. I worry that this will effect the early days of bonding with our baby, that it may result in less successful breastfeeding, etc, etc. I am sad about potentially having to choose baby’s birthday — I’d much rather allow baby to choose it’s own birth day/time. On the upside, yay medicine, yay technological advancement for the possibility of saving me from what would have been a death sentence in pre-c-section days.
Also, thank God for this one’s sweetness and comic relief. As I was taking the pics above, we caught her also posing – wearing my flip flops – against the garage. She asked Jason to take a pic of her baby, too. So so sweet.
So after wrestling with this for most of week 27, this week, I am letting go of what I cannot change — like the positioning of the placenta. Hoping for the best possible outcome for baby and for me. Embracing every moment that I’m up and playing with Lilly June (and not on bedrest/in a hospital/etc). Trying to get rid of whatever stress I can get rid of (because stress is pretty good at causing preterm labor, and right now I need TIME for this baby to stay in there and develop).