Third Trimester and Trucking Along

Well, we’re 31 weeks along now, three-quarters of the way!, (actually a bit more as I’ve noted below), well into viability, and actually facing the realization that we might soon be holding a baby. LittleFoot is growing, as evidenced by my belly really popping in the last few weeks. And for the moment, things are in a peaceful place, though getting a bit more uncomfortable with the extra set of growing elbows and knees on my insides. And I think I yawn-peed a little the other day (yes, kegels… I know.).

Before I begin the details of this update, I’d like to take a moment to express just how amazing my team of doctors, midwife, nurses, technicians, and staff are. We are both constantly feeling very well cared for, closely watched, and like they have our back. We feel treated like real people as well as comfortable in the notion that they are figuring out the best way for all of us to bring Little Foot into the world. A serious debt of gratitude to the Stanford medical crew for their care. They have been exceptional.

On to our Risk Factor Update:

Age (40)

Yep, I rounded the big 4 – 0 since our last post. And with that came a wild party attended by everyone I know and love with lots of hugs and general debauchery. Just kidding (thanks, COVID). I spent my birthday teaching and writing a quiz for my students. Wild times. But we did get delicious bbq (which gave me heartburn but was totally worth it), and Brian lovingly indulged my one birthday necessity – a Baskin Robbins silly monster ice cream cake (mint chip ice cream and chocolate cake for those needing to know) complete with extra hot fudge sauce.

Ah, but what about the pregnancy? Right, the real point of being here. Well, I did have a brief glucose scare. I didn’t pass my first glucose screening testing for possible gestational diabetes. So I had to go back for a 3 hour fasting glucose screening – a total of 12+ hours without food but including shotgunning one disgustingly sweet beverage. Seriously, I thought Hawaiian Punch flavoring died with the 90’s. Thankfully, Brian was with me for support (and in case I got sick or passed out – I didn’t – as was forewarned about this test) and my blood tests came back normal, so I think I’m in the clear now for gestational diabetes. I’ve also since learned that my diet is not one of the primary contributing factors to this condition (thank god. I’m addicted to Whole Foods brown butter chocolate chip cookies… and vanilla ice cream… and did I mention the birthday ice cream cake?). 

Congenital Heart Anomaly

So, I might have mentioned to my OB that I’d had a couple spells of wooziness since my last visit. Not dizziness, not fainting or light-headedness, but slight wooziness… like that in between stage of a drug rise where you think you might be feeling it a tiny bit, but it definitely hasn’t hit yet (not how I actually described it to my OB). Things are just slightly off. And while I thought she had told me I might expect a few of these as my blood volume increased, apparently the nature of the context around mine – seemingly out of the blue – warranted a little bit of concern. So I spent ten days as the proud wearer of a Zio patch, a round-the-clock heart monitor (yes, I could still take showers while wearing it). We’ll see if anything scary pops up. For now, we wait because, despite being pregnant and time being a bit more of the essence, it still takes 2-3 weeks to get results through the proper channels.

Pulmonary Valve Insufficiency

My second trimester echo and ekg showed normal pregnancy related changes, and all looked good! I’m scheduled again for another one at 33 weeks. Fingers crossed for no surprises.

In the meantime, I’ve been feeling quite good cardiac-wise. Of course, I’m a bit more winded going up stairs, and I have definitely slowed down and fatigue more quickly on our hikes. I may not have mentioned our hikes before this… Hmm, well, hiking is my main source of exercise and outdoor medicine as well as one of Brian and my favorite ways of spending time together (you probably already know that). It has been for a few years now, and we’d like to keep doing it as long as possible. I really had no clue if I’d be able to continue it at this point in the pregnancy. But we are still getting out about 3 times a week for hiking in the nearby hills. And it’s felt wonderful. Lots of short stops on the uphills, more frequent water breaks, and I could mark up a map of all the quality pee spots along our trails (and some not-so-quality spots – nothing like a Little Foot bouncing on the bladder to necessitate my own marking of half the trees on our hikes), but hey, we’ll definitely do what we have to to enjoy this part of nature before a long break for birth healing and a who-knows-how-extreme fire season.

Unicornuate Uterus

I didn’t have to have my cervix sewn shut. Yay! No more trans-vaginal ultrasounds. Yay! My uterus is still stretching to accommodate LittleFoot’s growth. Yay!

I’m now getting growth ultrasounds every four weeks, and it’s so exciting! In the last one, LittleFoot was in a full pike position with her legs up over her head and was holding on to her feet. We were glowing and giggling for days over that.

Additionally, next week we begin non-stress tests to monitor Little Foot’s heart rate and movement. From what I’ve read, this involves putting a monitoring belt around me for about 30 min and watching her heart rate during rest and movement. Apparently, her heart rate is supposed to increase with movement, and if it doesn’t, that could be a sign that she is not getting enough oxygen, indicating insufficient blood flow through the placenta. This is a risk that I possess in part due to being the bearer of only one artery connecting to the uterus. In a full uterus, there are arteries connecting from both sides of the body.

In the meantime, we have been monitoring her movements at home, and she is a squirmer! I think we’ve identified a few distinct movements including, kicking, hiccups, and flip-turns of the uterin side wall.

And some of my favorite moments so far are watching Brian feel and react to her movements. “Woah!” “Was that her?!” “Does that keep you up at night?!” “That was huge!”

Birthing

Since writing you last, I have had several more people exploring my vagina than, I think, at any previous time in my life. And the conclusion they came to was that I could possibly be okay giving birth vaginally. There is nothing really preventative toward that route. But I also might not be okay. It was a gray area, as all areas seem to be. And if I ended up needing a cesarean in the middle of birthing, it would be bad news to have to do that as an emergency procedure given the possible complications that might have to be dealt with upon opening me up. But, in the end, the doctors left it as our decision as to how we wanted to construct our initial birth plan.

The long and short of it is that we have decided to go the safe route and schedule a C-birth. (A neighbor friend of ours shared that term as a way of honoring C-sections as birth, rather than just surgery, and I love it. So, we’re trying to adjust our language). Upon consulting with my OB, she decided it would be safest all around to schedule it at 37 weeks – full term but on the early end (thus, we are well more than 3/4 of the way!). This means that Little Foot’s latest possible birthday will be June 29th. Of course, Little Foot may decide to come before then. But if not, mark your calendars! June 29th will be the day!… and send some extra love to Brian who will be our birthing coach throughout the surgery and support crew post birth and while I’m healing (not that we will be alone in this… we are blessed with a wonderful support network… but he’s still the one in it 24/7 with me).

Additionally, we will be relocated closer to the hospital for the two weeks prior due to continued risk of premature labor as we near the zeroeth hour. A rather cush service offered by Stanford for those of us living far enough away from the hospital that a long, in-labor commute would be, well, unfortunate at the least. So, team Westlander is now preparing not only for all things baby and a C-birth, but also for a lovely two week family vacay in beautiful, sunny, Palo Alto, CA… possibly even at the Ronald McDonald house… stay tuned for further details.