Wednesday, March 10, 2010

26 Wks, 1 Day: Perfect?

On Monday, I had my 26-week appointment. Other than losing 12 pounds last month, the pregnancy got a perfect bill of health: perfect blood pressure, perfect 3-hour glucose tolereance test results, perfect little heartbeat, perfect height of fundus. Perfect, other than the contractions and preterm labor that plague me.

By some pregnancy books, have started the last trimester and by others, it will not start until 2 weeks from now, at the 28-week mark. But either way, wow!!! At times, it seems like this pregnancy has lasted forever. At other times, it seems like the time has flown. And other than being on bedrest and having the preterm labor issues, I feel great. My body has adapted to the brethine pump, so I no longer feel the insane tachycardia and jitteriness that goes with it, even after they increased my dosages this past weekend. I'm not nauseated, don't have crazy heartburn, am not as sore as I was in the first trimester. Other than some pain in my left hip, which is sure to be nothing more than pregnancy-induced sciatica, and Zachary's wonderful kicks and punches, I wouldn't even tell you I feel pregnant. I do feel fat, but I have this great baby belly. With E, I just looked horribly obese, to the point that people couldn't even tell I was pregnant. But this time? Ummmm......not the case.

I am starting to get a little apprehensive about the delivery. My doctors tell me they are going to stop everything at 34 weeks, which is when I had E. I am having a repeat c-section and am not even given the option of a VBAC, but they won't even schedule it. One of the joys of having a scheduled c-section is that you know, without a doubt, when your child will be born. You literally get to pick their birthday. But they know that as soon as the brethine pump and progesterone shots are stopped, I am going to go into labor on my own, making any attempt at planning null and void. And I know that, after the prenatal care I have had, the close watch they have kept on Zachary, the steroids, and more, that they will deliver him then. But do I want them to?

This brings up a question of how truly lucky were we with E? I have learned in my line of work that a 34-week preemie can be perfectly healthy or they can have problems. It can go either way. E was perfect: over 6 pounds, which is big for a 34-weeker, but still small. I'm not sure, but even if he would have been full-term, he may not have even been considered low-birth-weight at that weight. He may have tottered on the edge of that line, but I don't think he crossed it. I remember him as baby: he was pefect. Petite features, pefectly proportioned. He was a little on the long side for his gestational age, making him even skinnier as his 6 pounds was distributed over more body length. And I didn't see him immediately after delivery, but I know he didn't even need suctioning, which is so commonly needed for c-section babies, as the trip through the birth canal doesn't occur to squeeze the fluid from the little airway. My mother-in-law was there, taking pictures of him, and I remember her telling me that he cried and screamed when someone would pick him up, but as soon as they laid him in warmer, he would be quiet and still and just look around, as if to say "leave me alone, people, and let me check out my new world". When I was finally taken to the recovery room, and got to hold him, he was perfectly quiet and still, laying there wrapped in his little bundle, on my chest. The only negative thought I could have about his birth is that he couldn't latch on, making our attempt at nursing in recovery awkward and leading to bottle feeding instead of breastfeeding as I had intended. That had as much to do with me as it did with him. Neither of us were in it at the time.

So back to Zachary: If I let them deliver him at 34 weeks from horrific contactions that aren't producing cervical changes, am I taking too big a risk? Because delivery at that stage would be for me, not him. And doctors can tell me what they think the odds are, but even if I were to deliver at a perfect 40-week mark, no one can guaruntee a healthy baby. In this cruel world, babies that seem perfectly healthy in utero can emerge with anomalies no one could have predicted. I am saying all of this now, but at 26 weeks, I can already tell that the contractions are getting more frequent, are harder to make go away, and are more and more painful with each passing week. How bad will they be at 34 weeks? How much will I be able to take? Is the gamble too great a risk?

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