I woke up early full of excitement about my BPP U/S (biophysical profile Ultrasound) to get a sense of how big the baby is and make sure things look Ok in there. There are a couple of concerns with post date babies other than size, like declining amniotic fluid levels and exchange between baby and placenta.

In order to get a growth estimate they need all these specific measurements which then calculate into some formula and then they tell you how big the baby is.

Everything started out well enough, until the tech asked me “Is your husband short?”

Me: “What? No, he’s 6′1″, why is the baby too short??”

Tech: “No.. just curious”

(Me: yeah right!)

Then she proceeds to take the femur length measurement about 100 times. At this point I know something is wrong…

“Is there something wrong with his leg?” I ask.

Turns out there’s this screen at the end of a BPP that shows you what weeks and days all the measurements come out to. Baby’s head is appropriately sized for 40 weeks 5 days, (i.e. big!) and his abdomen too. But the first measurements she got of his leg was for just 37 weeks and change. After trying to get better angles she managed to up this to 38 weeks, but I could tell it still isn’t enough because she talked about getting a colleague in there to try to get a better shot etc. You know it’s bad when they need someone else to take a look!

After we’d been at it for over an hour, she tried to reassure me that it’s probably something technical, i.e the measurement is off and that I shouldn’t worry etc.

Telling me not to worry is a complete exercise in futility – worrying is second nature to me, and when I think there is something wrong with my baby, there is NO stopping my head from constructing the worse possible scenarios.

After the U/S I went up to L&D for a Non Stress Test (NST) and to go over the U/S results with the Midwife on call Judy, who happened to be the midwife I saw at my last 40 week appointment.

Everything but the leg came back normal, though they did estimate his weight at 8lbs 8 oz. and based on ALL the measurements put my due date at 8/17/08 rather than 8/10/08. I guess everything but his head measured a bit behind?  But how could he be a week behind and weight that much? It doesn’t even make sense.

Judy agreed. She palpated my stomach and said she really didn’t think he was 8.5 lbs. I voiced my concern over the leg measurement and she told me that a 38 week leg measurement is a term measurement and I shouldn’t worry.

She also shared with me that at one of her son’s growth scans the tech told her his limbs were the size of dwarfism limbs! She was trying to make me feel better, but then she did say he is really short (though definitely NOT a dwarf.)   So I guess maybe Jasper will just be really really short? I’m not sure what to make of all this.

Of course I googled short femur measurement and immediately wished I hadn’t. There are all sorts of genetic disorders that this can be a marker for, even developing this late in the game. Things like Down’s syndrome, dwarfism etc. etc.

I know 38 weeks doesn’t seem like that far behind in measurements, but at this point I’m 2 days shy of 41 weeks, so it’s 3 weeks behind which is several standard deviations below normal. The midwife isn’t concerned at all, but that is small comfort to me when it comes to my baby!

In terms of progress news, she also did an internal and said I’m now a “Loose” 1cm, about 60% effaced and -1 station. So that’s a tiny bit of progress.. maybe the acupuncture session last night had some effect.

She also said they won’t let me go all the way until 42 weeks, I need to have the baby before then. They also don’t like to induce over the weekend, so if I don’t go into spontaneous labor (and she told me she thought I would within a few days) we’re looking at a next Thursday or latest next Friday induction.

Now I don’t give a rat’s ass about any of that though.. I just want to know he’s healthy. Short little legs and all :(

Because this post will be very long and wordy, here is a belly pic at 32.5 weeks:

How much bigger can she get? Stay tuned. 7.5 more weeks to go!

Ok, onto the preterm labor stuff..

So Saturday we went to my dad’s family picnic in Pennsylvania. On the way back during the 2.5 hour car ride I started contracting… and contracting and contracting. I’ve been having contractions since my last episode, but nothing like this.

Just the day before with my midwife we were discussing how she was worried how I would know when I really needed to go back to the hospital to stop the contractions given that I have them so often. I told her I thought I would know, that they would feel different and not stop like they normally do.

Well these sure felt different.. I was crampy even down in my legs and in my back and these were actually painful unlike the other ones that were just tight. Plus they were incredibly consistent coming every 2-4 minutes for over an hour. Some were so strong I couldn’t even talk through them!

I told my mom who was driving that I thought she’d better take me right to our local hospital when we got back in our home area. This turned out to be a mistake..

My midwife had told me that if I needed to, I could go to any hospital because preterm contractions are considered an emergency that needs to be stopped. I figured I’d go to Good Sam because I had been there the week before for my cervical length ultrasound and at least they’d have me and my insurance information in their system.

I couldn’t believe how rude the nurses and the OB on call were!

They kept asking me why I had switched from Good Sam to Phelps. And when I said I wanted to be delivered by midwives the nurse said “We have midwives here you know.” The OB on call kept making comments about how strange it was that after the first episode they didn’t put me on Brethine for the rest of my pregnancy to keep the contractions at bay (um, because it’s a drug that makes you feel pretty awful most of the time, it makes your heart race!) etc.

Anyway, they put me on the monitor and immediately put in an IV and gave me a shot of terbutaline and said I’d have to stay another hour on the monitor. By now we know the drill.

At this point, its midnight so we are both very very tired. And I don’t know if you’ve ever been in one, but I find hospital beds to be the most uncomfortable things, particularly when you can’t shift/move around without setting off the contraction monitor or losing the baby’s heartbeat.

We have about 5 minutes left until our hour is up.. and of course, I start contracting again. Damn, another hour, another shot of terbutaline.

Finally at 3:30am they discharged me after I’d gone an hour with only minor contractions. Actually, I think I was having more than were showing up on their monitor due to adjusting it, but I wasn’t going to tell them because at that point I just wanted to go home!

I’m a little worried that if I have one more episode like this they may put me on bedrest.. but for now things seem to be OK. My midwives are monitoring me weekly (instead of bi weekly) now, so we’ll see what they say friday.

I just really want to stay out of the hospital until it’s for reals. Hopefully at full term!

I had the sweetest ultrasound tech in the world. He’s a young dad of three, and he took the time to show me and explain everything he was looking at including even drawing me a diagram of cervical shapes etc. What a sweetheart.

Jasper scored an 8 out of 8 on the BPP (Biophysical profile) for which you get 2 points each for amniotic fluid level, tone (fetal movement), breath tones (lung function) and growth (femur length.)

He showed me the various pockets of amniotic fluid, where they were and how the measured them, my level was a very nice 15.5.  Honestly baby didn’t look much different than he did at 20 weeks, but it was pretty cool to see his little chest expand while he was taking breaths.

His femur measured for 30 weeks and a few days, so right on track.  He turned on the sound and the heat sensor thingy that shows the umbilical cord exchange between my blood and baby’s and everything looked good there too, so overall, no reason that little Jasper should be quite so eager to get out yet.

I called Lisha the head midwife at Open Door as she was the midwife on call yesterday in L&D. I haven’t met her in person but I love her already. She told me that in light of those results, no bedrest necessary, but also need to take it easy until 36 weeks. I.e. no gym for me or any other strenuous activities (including sex.)

Also, my urine culture and GB strep test came back negative, so I can stop taking the antibiotics they gave me as a precautionary measure.

So the news is all good, now I can return to happier blogging topics like nursery decorating and baby products!!

:)

Saturday night I was still having contractions, but not as much yesterday day… until they got me hooked up for my monitoring at the hospital. The midwife had ordered an hour of monitoring along with my second shot of steroids to mature jasper’s lungs.

For the first 15 minutes, other than his extreme hyperactivity (calm down in there baby boy, you’re already wearing your old mamma out!) everything was uneventful.. but then, the contractions started again and went on for another 45 minutes. Some were pretty small, but there were a couple that almost felt like mild labor contractions, really strong and with some pain in my lower abdomen.

I couldn’t see the output of the monitor, and kept asking my mom if it was picking up the contractions because the day before, if I started contracting heavily they’d run into the room to see me.  Turns out the monitor wasn’t tight or low enough. After they readjusted they could see them register and I had a couple more big ones and a bunch of smaller.

The Midwife on call was Patricia, the one I’d seen at the clinic on Friday. She was really sweet and teased me that didn’t I know they only delivered “normal full term babies at phelps??” I told her I just couldn’t wait to see them again. Anyway, after my second shot of steroids, she did another internal and said my cervix felt about the same as from yesterday, still high and closed (very good) but soft (not as good).

Since there was no cervical change as a result of the contractions, she left it up to me if I wanted a shot of terbutaline to stop the current contractions I was having.  I declined since she said it would only help for a short time anyway.

The good news is she said I didn’t really need to be on bedrest. I am going for an ultrasound today to my more local hospital to get the cervical length and shape checked, and also what they call bpp (bio physical profile) of the baby to make sure the placenta, baby and amniotic fluid levels seem ok. I hope that everything is alright in there and that his recent hyperactivity isn’t a result of him NEEDING to come out for some reason!

Patricia also mentioned that the one time I did have my cervix measured at my 20 week big ultrasound, it wasn’t that big anyway (3.4) so it won’t be surprising if its pretty low now. She said normal is closer to 5 to begin with.. but more importantly, we don’t want to see any funneling, or the shape changing from a closed T to a more open U type shape.

So, stay tuned, ultrasound at 1pm.. I’ll update this afternoon hopefully with good news.

Thanks again for all your well wishes :)