Pregnancy with a toddler in the summer

… Kind of sucks. Growing a human is beautiful and I can’t wait to meet this little boy, but oh my goodness this is so much harder than the first time. 

I’m 34 weeks pregnant and we’ve been going through a heat wave here in NYC, with lots of hot, humid days with a heat index above 105° F. I’ve never been a summer person, preferring cool weather or even a rainy or snowy day to the clear skies with the burning sun. 

So this summer, with the heat wave, the third trimester, and the challenges of parenting a toddler… I’ve felt a bit like I’m melting to pieces. Many times it’s all I can do to get through the hour or the day. Tears seem to fall more easily. I go to sleep when my daughter does most nights, spending 10 hours in bed, and often still want a nap. 

I’m getting better at managing, though. I’ve been frank with my husband about the support I need, lowered my expectations of myself, set an earlier start to my leave (less than 3 weeks to go!), built more rest and refreshment time into my days, and also spoke with my doctors and increased my anti-depressants. All of this is helping, and I’m feeling more stable and ready and in control. We’ve made it to mid-August and there’s just a little summer left. 

One day soon, I will walk outside into a cool fall breeze, holding my new baby and watching my toddler and husband play, and it will be beautiful. 

Our daughter is here!

Our daughter was born on Jan 9 at 3:21 am. She weighed 6 lbs 12 oz and was 20 inches long.

The labor was eventful and I’ll post a full labor story when I have time. The short version begins with me being in early labor before the induction which started at noon on Wednesday. I was given 2 doses of cytotec to get me ready for pitocin, and then I was well into active labor by the end of the 2nd (4 hour) dose. Though I was only 3 cm, labor was progressing so well we never used the pitocin! By 1 am Thursday I was fully dilated. I pushed from 2 am and she was born vaginally with vacuum assistance at 3:21 am.

She’s now 9 days old and the time has flown by! Some days have been calm and others more stressful, but w are thankful for each one of them!

I’ll post more pics once I download the ones from the camera. For now, here’s one at about a week old.

I will meet my baby in a day or two!

After my appointment on Monday Hubby and I did some more research on Gestational Hypertension (GH), trying to find out more about the risks for mother and baby and the reasons why doctors would deliver you early because of it. It was easy to find that it is definitely standard practice, but most of the time was not accompanied with much in the way of compelling details as to why this would be better than regular monitoring and induction only if things got worse, which seemed to us to be a logical approach for mild hypertension.

But then we found a thorough study out of the Netherlands called the Hypistat study, which compared induction vs expectant monitoring for mild GH and pre-eclampsia. Surprisingly, it showed that those who got induced not only had lower rates of maternal complications, but also had lower rates of c-sections! Apparently if you have even mild GH and it has time to progress, your body may not be able to handle labor as well, so you are more likely to need an emergency c-section than if you get induced before the GH gets worse or develops into pre-eclampsia. Since fear that it would end in c-section was probably our biggest reason for reluctance to induce, finding this info really called me down.

So on Friday I went in for an ultrasound and everything checked out fine – baby’s fluid levels and movement were normal. Then I went in to the doctor for another check up. My BP was as high as the high ones the week before. I was a little bummed as I guess I’d been going against reason that it would just drop on its own. But the doctor said it was good that it hadn’t risen further.

Then they checked my cervix to see if I was progressing at all on my own. I should mention that while I’ve been uncomfortable for weeks, with cramps and Braxton Hicks contractions, lower back pain, and lots of pressure on my pelvis from baby, I had noticed on Friday a distinct increase in the pressure and the sensation that there really was a baby’s head in my pelvis!

So I was glad to hear that the discomfort had been productive – I was dilated 1/2 cm, 50% effaced, and baby was at -2 station.

I talked through more of the induction process with the doctor. We are scheduled to be at the hospital at 8 am tomorrow, and he said it usually takes about 24 hours from admittance so the baby will most likely be delivered on Thursday, when he is in.

That night Hubby and I talked through it further, and decided that we agree that it is best to go forward with the induction. Since then we have been relaxing and doing final preparation. Today we are so excited, it’s like being a kid the day before Christmas! We will meet our little girl by the end of the week!

38 weeks & gestational hypertension

So at my second appt last week my BP was high again at about 140/80, and the doctor diagnosed gestational hypertension. The basic urine tests were coming back normal but because of the hypertension they requested a 24 test to rule out pre-eclampsia. The results came back as normal – Phew.

That appointment Thursday wasn’t with my regular doctor, so I had a follow up Monday with my OB. We knew that since the results from the prior Thursday confirmed hypertension, he would want to induce before my due date.

Since we have been preparing and hoping for a natural birth, we aren’t taking the decision to induce lightly. Induction usually means constant monitoring instead of intermittent, which means less ability to move around and use some of the natural pain management techniques that we practiced. It also means they give you pitocin, which is a synthetic form of oxytocin and can cause contractions to be stronger and more frequent.

Hubby was working so he joined us on speakerphone to talk through the risks and benefits. The Dr said that gestational hypertension often gets worse and can change quickly, which is why they recommend induction. The primary concern for the baby is related to the placenta and cord providing nourishment properly with the increased pressure on the blood vessels.

At the appointment Monday my bp was slightly better, so the doctor agreed to push the induction/delivery from Sat (today!) to the following Thursday, which is the day before my LMP-based due date of Jan 10 (I’ve been going by my ovulation-based due date of Jan 13 for my posts here).

So I left the appointment on Monday with another appt and an ultrasound scheduled for Friday, still feeling a little unsure, but glad that we’d gotten a bit more time before an induction.

Next post I’ll tell you how the Friday appointments went. Right now, this pregnant mama needs a nap!

Merry Christmas!

At the end of last week I caught a cold, and for several days on top of waking up to pee I would wake up with a very sore throat and congestion. I was mostly sleeping in 2 hour chunks, and then having to go to work.

This morning, I woke up and just felt in my body that I had slept for longer. I looked at the clock and saw I had slept over 5 hours straight! Then after using the bathroom and clearing my congestion as much as I could, I went back to bed for another 4 hour stretch of sleep.

I feel better than I have in days! What a wonderful Christmas gift from Santa for this pregnant mama!

Also, an update on the blood pressure: I checked at home later that day and it was very healthy again. I checked yesterday evening and it was up again, though not quite as high as it had been on Monday. When I go and see the doctor tomorrow in going to be sure to get there early and relax, and we’ll see what happens. I’ll probably finish some more hospital and baby prep at home today just in case.  I have a few more things to get ready, but we are just about there. Mostly I want to work on my quilt to finish it up!

Merry Christmas and a happy holiday season to all!

37 weeks – BP jumped

All pregnancy I’ve had really nice BP ratings of 110-120 over 70-80.

I’ve also had a lot of fluid retention and am very swollen. I was feeling particularly like I could burst today.

Then I had my OB appt and got a blood pressure reading of 140/80. If it’s high at the next appt (Thursday though not scheduled yet and the office is closed til then –  fun!) then they will want to induce before due date due to pre-eclampsia concerns, and if it’s high and there is protein in my urine they would induce that day. If it goes back down then we will continue to wait and watch for labor to stay on its own.

Hoping it goes down on its own!

Gestational Diabetes and pregnancy outcomes

I got my results from the 3 hour glucose tolerance test last week. I don’t have gestational diabetes. Phew!

But 2 of my 4 blood glucose measurements were pretty close to the cut off, and it only takes 2 of the 4 to be above the cut off to diagnose gestational diabetes. So really, with a slightly different evaluation, I might have gotten a positive result. While my result means I don’t need to start taking my blood sugar or go to a nutritionist and other extra doctor visits, I don’t really think it means I’m free and clear.

Being so close to the cut off made me think, how do they pick that cut off anyhow? Is there a gestational pre-diabetes similar to the adult categorization for people who have high blood sugar but not enough to be called diabetic?

So I did a little research. And what I found was not surprising – the risks for pregnancy outcomes associated with gestational diabetes actually increase along the continuous scale of blood glucose levels.

But this wasn’t always known. Just 2 years ago, a large, multicenter study known as HAPO demonstrated that having high results that aren’t quite enough to qualify as diabetic still results in increased amounts of higher birth weights, c-section births, newborns with high insulin at birth, and hypoglycemic newborns, and other issues. The study, Hyperglycemia and Adverse Pregnancy Outcomes, is available online. 

What’s a bit scary about this is that while the American Diabetic Association (ADA) has updated their guidelines based on the results of the HAPO study, the American College of Obstetricians and Gynecologists (ACOG) hasn’t yet adjusted any of their recommendations. So depending on your doctor, he or she might not tell you if your levels were high but not high enough to diagnose as gestational diabetes.

I always ask for copies of all of my lab results, and they usually come with the reference numbers. That’s how I know that if 2 of my readings had been just 5 points (3-5%) higher, I would have had a different outcome.

Gestational diabetes is usually a very manageable condition, so it’s not that I’m super worried about this. But I like to know the facts, and by my reading, the facts are that I am at a somewhat increased risk of having a large birthweight baby, a c-section, or a newborn with high insulin or hypoglycemia, which puts them at risk for weight difficulties later in life.

It seems the prudent thing to do is to pay more attention to my diet and exercise going forward. I’ve been doing prenatal yoga weekly and walking about 4 miles on weekdays, so I just need to step it up a little bit, and lay off the sweets a bit more. I can do this for me and my baby!