22 Weeks

I saw my OB, Dr. D, for my monthly check up this morning. It’s the first time I’ve seen her since being diagnosed with placenta previa and a succenturiate lobe so I had lots of questions.

A quick reminder:

Placenta previa (PP) is where the placenta covers the cervix which blocks the baby’s way out. It can partially or completely cover the cervix — in my case, it is totally covered. If it doesn’t move, I will need a caesarean.

The succenturiate lobe (SL) is an extra piece of placenta that is partially attached to the main “mothership” placenta. I liken it to being a thumb sticking out, like this drawing (left).

The SL puts me at risk for vasa previa, where a blood vessel covers the cervix. Because of its position, the blood vessel can easily rupture. If the blood vessel is the mother’s blood, she can haemmorrhage. If it’s baby’s blood, baby will quickly bleed to death. It’s obviously very serious…

I’ve been doing a lot of research on PP and SL, and had drawn some conclusions which Dr. D confirmed. (Go me for parsing medical data!) Here’s what I learned / had confirmed:

• It is unlikely that the placenta will have moved out of the way by the time I have my next ultrasound on July 25th.
• The placenta moving out the way is half the battle. Just because it moves out of the way does not mean that it moves the lobe further away from the cervix.
• The SL is the thing the doctors are most concerned about. If it moves closer to my cervix, the blood vessel will be in a dangerous location and could rupture, causing massive blood loss.
• I will be monitored closely, having high level ultrasounds every 4-6 weeks, until it’s determined that the placenta and lobe have moved.
• If both the placenta and the lobe move at least 2cms away from my cervix, I can deliver vaginally.
• If I just have PP and the SL is in a safe position, I will have a c-section around my due date of November 13th.
• If I am diagnosed with vasa previa, I will go on hospital bed rest and Baby V will be delivered by c-section between 36-37 weeks, between October 16th – 23rd.
• Dr. D can continue to see me for my check ups and also perform the c-section, even if I am on hospital bed rest and under the continuous care of the perinatologist team.

Dr. D and I discussed c-sections quite a bit. I began by saying how I am mentally preparing myself for a c-section. Towards the end of the appointment she said that I should probably forget about delivering at the birth center for now… I told her I had…

It was good to discuss my concerns. I explained that I am not squeamish — except for the idea of a catheter going in my spine — but that everyone I know who has had a caesarean has had a negative experience, including my mum. (She had a general anaesthetic, woke up halfway through surgery, could feel everything but couldn’t move, and they cut my sister’s head and she needed a stitch in the wound!)

Dr. D assured me that she will do everything she can to replicate the natural birth experience I so desire. DH can be in the OR with me. They can lower the curtain so I can see the baby being delivered. She will be immediately checked out, but if she’s doing fine they will put her on my chest while they stitch me up. If she needs extra attention, DH can go with her to the NICU; otherwise we won’t be separated.

Dr. D was also kind enough to share that she has had three caesareans. Was it what I wanted? No, she said. But with my first, I wasn’t progressing. And all that matters is that baby is healthy. The recovery isn’t bad either. It’s actually quite quick. My sinus surgery was much worse!

In the moment, I felt reassured. If I have to have a caesarean, there is no one I trust more than Dr. D. Plus, there is something to be said for continuity of care.

But, honestly, I feel really sad about it all. I feel guilty saying this, but haven’t I been through enough already? Haven’t I made enough compromises? I’ve lost a baby, had my fertility ground up in the sausage maker and spat out, and I’ve even had to say goodbye to passing on my genes. And now I’m dealing with more sacrifices:

• No possibility of relaxing and enjoying this pregnancy. How can I when I know I could start bleeding heavily at any time, not knowing if it’s my blood or baby’s blood?
• No exercise — goodbye, prenatal yoga classes…
• A new home I can’t unpack. I wonder for how long I can put up with living amongst boxes.
• No sex — ‘nough said.
• I probably can’t go to my sister-in-law’s wedding in North Carolina and won’t see DH for almost a week (I want him to go).
• A real possibility of bed rest IN HOSPITAL.
• A likely c-section.
• Baby likely to be delivered 3-4 weeks early if we’re lucky.
• Goodbye, natural childbirth.
• Goodbye, immediate breastfeeding.
• Goodbye, waiting for the placenta to stop pulsing before DH cuts it.
• Goodbye, placenta encapsulation.

I’ve had to accept so much, to have the last hope for an uneventful pregnancy followed by as close to a birth experience as I hoped just seems so fucking unfair. I know… I know… there’s no such thing as fair, especially not in the infertility and loss community. It just feels very distressing that I have to say goodbye to every fucking thing on my wishlist.

I had hoped that pregnancy and childbirth would be incredibly healing. I’ll be honest, it feels like another great blow. I know this is completely irrational, but I feel like because I didn’t conceive this baby, she’s not really mine. However irrational this may be, part of me wonders if I am her mother? Because if I neither created her, nor deliver her into the world, it feels like cheating.

I dare not daydream about this baby. I don’t call her by her name — I actually refer to her as “Baby V” in real life, even though my parents and sister call her by her name. If she dies, I can’t send my great-grandmother’s name to the grave with her. I’m sure this sounds cold and calculating. Perhaps even crazy. But there it is.

DH and I just had a talk. He was quick to agree that not having the crunch earth mother pregnancy and birth experience is a huge disappointment; but he also gently pointed out that although having hopes is good, having expectations can be dangerous. He reminded me that there is more to being a mother than how you bring a baby into the world and encouraged me to bond with the baby — I am the only mom she’ll ever have. This hurdle is just adding another layer to the story of how she came to be and how badly I wanted to be a mother.

Tears spilled down my cheeks, and when they dried I realised I am more determined than ever. I have plenty of fight left in me. Actually, because of this baby, I have more.

I can handle hospital bed rest. I’ll miss my dog, but maybe he can come visit me if I am allowed outside in a wheelchair. As DH said, we can figure it out if it comes to that.

I can handle a caesarean. This baby is strong and healthy. She can too.

All that matters is that Baby V arrive safely. I know this with every fibre of my being and I will do everything in my power — even if that means doing nothing — to make sure she arrives late October – mid-November.

Sweet baby just kicked a few times. Hey mama, I’m still here. She’s active all day, every day. Starting when I wake up in the middle of the night to pee, I feel her kick about every two hours, if not more. Sometimes it’s a kick, sometimes it’s a prod. Sometimes it feels like she’s strumming a Spanish guitar. Sometimes it feels like the fluttering sensation of heart palpitations, but below my navel. Sometimes it feels like she’s blowing bubbles, and other times I can tell she’s doing a somersault. I’ve felt her little head through my skin, like a tiny baseball, and I’ve seen it (I assume it’s her head) move from one side of my abdomen to the other. She’s in there. My long-legged active girl reminds me she is alive and kicking.

I’m going to try very hard to remember Dr. D’s best words today: An active baby is a happy baby. It means she’s getting everything she needs.

There are a lot of scary possibilities on the horizon, but maybe I’m doing a better job at being a mom-to-be than I give myself credit for.