32 Week New Plan in The REAL Baby Journey!

So I went in for a ‘follow up’ appt with my OB today to go over the ultrasound results from yesterday. I expected it to be routine and uneventful but, as seems to be the usual lately, things were a little different than expected.

My doctor started off by saying that along with the baby looking a bit small it also appears my amniotic fluid levels have dropped. They are half now what they were at 28 weeks and if they drop anymore by my first fluid level check next week, I might have to be induced next week. Cue some deep breathing and self relaxation techniques by myself in the doctor’s office.

The baby’s head is actually growing ahead of schedule (not shocking - my husband has one ginormous noggin) but the baby’s abdominal girth is actually measuring almost a month behind. This possibly means that my placenta isn’t giving adequate or consistent enough blood flow to the baby so it is shunting blood to the brain to try and help it grow faster with limited resources while sacrificing it from the kidneys/abdominal organs. If the kidneys don’t get adequate blood flow they don’t create as much urine and thus my amniotic fluid levels drop.

The doctor said I will do these twice weekly nonstress tests (heart rate monitors of the baby’s response to its own movement and its hearts ability to rebound during stress/agitation) and once weekly fluid level ultrasounds and go from there. If I ‘fail’ either of them (which is apparently not uncommon, as a few of you mentioned - false positives don’t mean something is urgently wrong) I would immediately go to the perinatology/high risk clinic downtown and get a biophysical profile done on the baby. This checks on the baby’s breathing rate (it is practice breathing to strengthen its diaphragm already - very cool), heart rate, movement rate, muscle tone and amniotic fluid levels. There are ‘normals’ for each of these and if the baby fails on this, I would be induced at that point. Phew.

The doctor’s recommendation was to finish up our nursery this week and get everything ready just incase the appointments don’t go as planned next week. He also said he would likely recommend induction at 37 weeks as monitoring a baby so closely at that point is somewhat silly as it is full term and likely will do just as well ‘outside’ as inside. No need to spend the money, time or resources/analysis when the baby could easily thrive outside of me and keeping it in with questionable oxygen delivery would be more high risk than removing it. I didn’t think I’d ever hear ‘the baby is better out than in’ but I suppose this would be that time. I’ve worked so hard to keep baby growing and safe and healthy in there it seems strange that as early as next week they might decide the little one is actually better outside of me than in, despite being barely (hopefully) 4 lbs.

The next concern is that if I do get induced next week or any time in the next month, the baby would likely not be ‘strong’ enough to tolerate a vaginal delivery. If the baby is failing these nonstress tests and they show it has inadequate oxygen while resting and calm, the process of labor and delivery could very likely be too stressful and may kill the baby. Thus, with additional testing to make sure I couldn’t delivery vaginally, I may end up with a c-section. I completely understand that however and would obviously never want the baby to be stressed or in distress to the point where its life is in danger.

We’ll play it by ear and wait for the appointments next week. If they go well, we continue on with this game plan and wait for the appointments the week after that. Repeat until 37 weeks or the baby ‘fails’ the tests. I asked if there is anything I can do that helps or hurts the situation and my doctor said to avoid anything that makes me short of breath and would possibly compromise oxygen flow to the baby. Beyond that, drinking plenty of water and resting are the best things. I can do that, around work of course. I work Thursday, Friday and Monday 12 hour shifts but my doctor said I should still keep up with that. Bedrest was mentioned including hospitalized bedrest with me on oxygen to hyperoxygenate my blood but that, at this point, the risks of strapping me to my bed are higher than the possible benefits. Slow, calm, relaxed, letting whatever shall be, be. Of course I want a healthy, strong little one out of this but it is so much out of my hands. I will do my best and try to keep growing someone in a body that’s trying its hardest but may ultimately not be able to do it.

Thoughts, prayers, hugs, kind words…all are so appreciated and treasured during this. Will update if anything else changes!

Last updated October 29, 2014