Due Date: Come and Gone!

We had a sonogram yesterday, Friday, June 15th, our due date. This is a standard procedure at the 40-week mark, and it's called a BPP (biophysical profile) to monitor fetal heart rate continuously for 20+ minutes, check the reflexes of the baby, measure amniotic fluid levels, etc.

According to measurements taken yesterday, the Bean is already 8 pounds, 8 ounces! The baby gains almost half a pound each week now.

The due date is the midpoint of the last 4 weeks of the pregnancy. Roughly 5% of pregnant women deliver on their due date according to Dr. Holden, and the rest come earlier or later. Senan (Emma's son) was born 5 days after his due date, Ben and I came after our due dates, and Bean is carrying on in the Renda tradition of being late.

It's funny to think I actually look forward to cramps and backaches. My parents and Michael ask "How are you feeling?" and I say "perfectly fine, unfortunately", and we all laugh. Ready to have the baby out now.

We saw the Bean's face and head even though it's down low. The radiologist said the Bean was making chewing/sucking motions. I hope that bodes well for breastfeeding attempts after the birth.

I find it emotional and difficult to look at our ultrasounds. We saw outlines of the external features, and the skeletal structure underneath, and he/she still looks like ET (!). I love the baby already whatever he'll/she'll look like, so I just want the radiologist to look on my behalf and tell me/us everything is ok. She said everything looked fine.

It is easy to get anxious at ultrasounds. Even though we had genetic testing and blood tests early in the pregnancy, there are a million other developmental issues that can happen along the way that can't be tested for in advance, that are unrelated to age and are out of the parents control (including things like cleft palate) so you find yourself shoving these worries to the back of your mind, hoping for the best, and watching the face of the radiologist very closely to insure he/she doesn't get a concerned look...

Last night, my parents and Michael and I walked to a restaurant in North Park Slope called the Chip Shop -- it's modeled directly on the UK Chip Shops and features meat pies, fish and chips, curry and chips, chips & butty, bangers & mash and more. We had great fish and chips and Michael tried a fried Mars Bar, which is a candy bar deep fried in batter (a donut!) covered in powder sugar. Heart attack on a plate. It reminded me of living in England.

We walked home and I had cramps for the rest of the evening, so we all went to bed optimistic that this might be real labor starting, but I fell asleep around midnight and woke up 8 hours later, so obviously it wasn't...

Today is my father's birthday! We were hoping the Bean would be born today, but unless something dramatic happens this afternoon, probably not. Mom made lamb chops for dinner, we had birthday cake and gave Dad a few presents. I'll post a picture here soon from our party of four (+1).

Above are two pictures from the two recent sonograms we've had - it shows the outline of Bean's head (June 15th), and one of Bean's feet (May 30th).

Weekly Checkup: No News & Weird Thing in Toilet... (Wednesday, June 13)

Vitals: 110/70
Weight: same as last week
Fetal heartbeat: good

We saw Dr. Holden today, and for the first time I was looking forward to him checking me out to see if I'm dilated (even though it hurts a bit). Was hoping that the cramping this week was a sign that things are moving along here. This is expected to be our last doctor visit before the birth.

He said I'm dilated ~2 centimeters and softer than last week, which are good signs but not necessarily indicators that we'll go into labor naturally soon, so I am a little disappointed. The cramps have diminished so doesn't seem like much is happening.

Our official due date is the day after tomorrow (Friday, June 15th). As per the discussion we had with Dr. Holden at last week's appointment, the latest we'll be allowed to wait for something to happen naturally will be next Thursday, June 21st. Since Dr. Holden is on duty next Tuesday, he recommended we formally book in to the hospital on Monday, and he'll deliver us either Monday or Tuesday (!). We can opt to wait until Thursday; the downside is we probably won't get Dr. Holden.

Michael and I would both like it if we went into labor naturally, so we're hoping something happens this weekend (but right now, it doesn't feel like much will happen...). We are scheduled to show up at Columbia Presbyterian next Monday at 6 a.m. eastern if nothing develops this weekend.

Dr. Holden said it would be normal to spot or cramp up after the appointment. After dinner, I went to the bathroom (pee), and found something weird in the toilet. Sort of light brown and scalloped... I called my Mom in and we both looked. Maybe mucous plug?
http://www.justmommies.com/articles/mucous-plug.shtml
Not sure, but hope that's what it was.

Some of the best laughs Michael and I have had this pregnancy have been around bathroom issues in the last trimester. One incident (#2) happened at the old apartment; and another incident (#1) happened at a recent doctor visit when I was trying to provide a urine sample. I'll write separate entries later with a warning up front in case anyone wants to be spared the bathroom humor. It's worth recording to me because it will capture at least two times Michael and I couldn't stop laughing recently. The closer the due date, the less the dignity...

Weekly Checkup & Countdown (Wednesday, June 6)

Weight: 181

Vitals: 120/60

Fetal heartbeat: good

Michael and I met Dr. Holden today. Our due date is next Friday, June 15th, so we're about 9 days away, though only 5% of women deliver on their actual due date -- roughly half go early and half go later.

Urine, blood pressure, weight and fetal heartbeat tested -- all fine. We asked what happens if we go past due date and there's no development, and Dr. Holden said the policy across different hospitals varies, but at Columbia, they won't let the baby come more than 1 week late (week 41). There's evidence that the probability of fetal distress increases dramatically between weeks 41 and 42 and beyond, so they'll induce labor after one week past the due date. Since Dr. Holden is on call Tuesdays and the weekends, if the Bean doesn't arrive naturally the weekend of the 16th/17th (due date), then we may induce on Monday, the 18th, with the expectation I'll deliver on Tuesday, the 19th when Dr. Holden is on call.

He did a quick internal exam and said I'm approximately 1 centimeter dilated and cervix is much softer than when he last saw me two weeks ago. We'll see him again next week...

Weekly check-up & Sonogram (May 30th)

Weight: Same as last week
Vitals: 120/70
Fetal heartbeat: 143-147 bpm (good)
Test result: Strep B - Negative (good!)

Michael and I met Dr. Eileen DeMarco today. She's nice -- very business-like. Felt the baby, confirmed head is down, said 'medium-sized' -- in the 7 pound range. Did an internal inspection -- said I'm starting to efface, but not dilated significantly. She mentioned she's on call on Fridays (June 15th is a Friday) but not the weekend of the 16th-17th, so it is a lottery in terms of which doctor will be on call when it's time to deliver.

The only thing on my mind was lack of movement. The Bean has been active every day for the past several weeks at many points throughout the day and night so that I've had no second thoughts about tracking fetal movement. Yesterday, I spent a good chunk of the day outdoors doing errands, and felt movement only twice, and none at night when I went to bed. This morning was very quiet -- no movement.

Dr. DeMarco said it's likely everything is ok, but indicated we should get a sonogram to check measurements and amniotic fluid levels to be safe. It's fairly routine to have a sonogram around week 38.

We were asked to stay and get the sonogram today, so Michael and I went to lunch and came back. The same radiologist who did our 19-week sonogram performed today's scan. Because the baby is big now, it was not easy to understand what was on the screen, and we couldn't tell what we were seeing. The radiologist said the baby looks fine: heartbeat, proportions and fluid levels all good and weight is 7 pounds 2 ounces based on the measurements! There was a good shot of a foot, so she printed that out for us to take home. I'll post it here once Michael gets home and we can scan it. She said we'll be fine and encouraged me to give the Bean a poke once in awhile if he/she has been dormant for a long time.

One thing I noticed: the radiologist referred to the Bean as 'him'!

37-Week Checkup (May 23, 2007)

Weight: 178 pounds
Vitals: 100/60
Fetal heartbeat: good

Dad left this morning after a two-week visit to assist us with making the move to the new condo. His help was a huge benefit to us, and we couldn't have gotten sorted so quickly without him. Thank you, Dad!

Michael and I went to the doctor appointment together. Melissa, the nurse, took weight, urine, blood pressure and listened for fetal heartbeat. Urine test was fine, and fetal heartbeat was good (we could see the baby moving while I was laying back on the table). Dr. Holden explained that he'd do a Strep B test and check my cervix for dilation and the position of the fetus. When he checked for dilation, it hurt a bit. He said the baby's head is way down, and I'm approximately one centimeter dilated. He also said the baby doesn't feel too big, and estimates it will be in the 7-pound range.

The baby could arrive anytime week 38 - 41, which is good news. It would be ideal if the Bean held off at least one more week so Michael and I can finish unpacking and get organized. We aren't ready for the baby yet... no place for baby to sleep, too many boxes in the bedroom and baby clothes not washed yet.

Dr. Holden said Strep B is present in all adults, but in about 20% of women, it is present in the vagina and poses a threat to the baby during birth -- the major risk is pneumonia in the newborn. If I test positive for Strep B, I'll receive antibiotics intravenously as soon as I check in to the hospital for delivery, and the baby will be held for 48 hours after birth for evaluation by a pediatrician to insure that the baby is not adversely affected. The worst case scenario (low probability but a possibility) is that baby develops a fever and gets sick, which typically requires a 2-week stay in the hospital. We'll get the Strep test results middle of next week.

-Called pediatricians in Brooklyn today and found several who are willing to take on a new patient. None were available to meet us before the due date, but said we could bring the Bean in within 3 days after birth and get started.

-Discovered the "R" subway line connects the stop nearest our condo (Prospect Ave) to 59th Street/5th Ave, which is the closest stop to Dr. Holden's office at the Eastside location. The ride takes about 65 minutes. It is nice to be able to stay on one train for the whole ride.

35/36-week Check-up (Wednesday, May 16)

Weight: 177 (I think I'm retaining at least 2 pounds of water in my ankles)
Vitals: 100/60
Fetal heartbeat: good

Michael and I met Dr. Shinn today, one of the five doctors in the practice with Dr. Holden. He measured my abdomen and said we are on target size-wise for 35-36 weeks (I'll be at the 36-week mark on Friday). Once week 36 hits, he said the baby could come anytime, but normally comes within a week of the due date (before or after). He clarified when we should call if we go into labor and said everything looks fine so far.

Next week we will see Dr. Holden. Tonight we had our last Birth Preparation course. Practiced breathing, covered breast feeding in a lot more detail, discussed bathing the baby, etc. Michael and I talked in the cab ride home, and agreed that we feel like we are in reasonable shape to cope with the baby when he/she arrives (famous last words).

33 week check-up (Wednesday, May 2)

Weight: 175 pounds (same as last visit -- thank heavens); Vitals: 120/80

Michael and I saw Dr. Holden today. The Bean's heartbeat sounded good, and Dr. Holden said that we are on target and progressing normally. He indicated we'll have one more sonogram -- on or near the due date, and will start seeing him weekly around 36 weeks. Next visit, I'll be tested for Group B Strep (http://www.babycenter.com/refcap/pregnancy/prenatalhealth/1647.html). We will also meet two other doctors in the practice who share on-call responsibilities.

We went to our first Birth Preparation class tonight, taught by Fern Drillings, the woman who also instructed us in the Baby CPR class. There are about 15 couples in the class, all due this summer. One other woman and I are the two scheduled to deliver the soonest.
There is couple in the class expecting twins, and one couple that looks a lot younger than the rest of us -- in their early or mid-twenties -- and both women look great. No extra weight anywhere except their bellies.

I used to fantasize that it would be great to have twins so that we'd have two kids at the same time and could get all the vaginal deliveries/pain out of the way at once. Now that I've been through the drill with this single pregnancy, including digesting all the probabilities of potential problems for singletons, twins and multiples, I realized a singleton is plenty. There's a lot more to stress about with two in the oven at the same time... What if you only felt one move, and not the other, or the nurse could only find one baby's heartbeat and not the other's at an exam? etc.

There were some weird questions by some of the fathers in the class tonight:
+ Do I HAVE to hold my wife's hand during the delivery? (He was afraid his wife would break his hand by squeezing too hard during her labor. Fern's answer: You'll do whatever she tells you to do.)
+ Is there a sheet or barrier that shields her lower half during delivery? (He doesn't want to see the blood and stuff around the delivery... Fern's answer: No barrier, no sheet. It's all there and you'll be seeing it all, so if you can't handle the blood and stuff, ask for a chair and sit 'upstream' near your wife's shoulders, or leave the room.)

The winner of the weirdest question award goes to a father in Emma & Alan's birth class. Emma told me that when she and Alan went to Birth classes in San Francisco to prepare for Senan's arrival, one of the fathers in their class asked if he could breast feed the baby himself too, acknowledging he wouldn't be providing any milk, but wanting the bonding opportunity (!)...

8-month Checkup (April 20, 2007)

Weight: 175 pounds (40+ pound gain since getting pregnant!)
Blood pressure: 110/70

I met Dr. Hadden today as part of a rotation every two weeks to meet all 5 doctors that take turns being on duty for the labor/delivery ward at Columbia Presbyterian. By doing this, whichever doctor is on duty in the labor/delivery ward and I will be somewhat familiar when the time comes to deliver.

Dr. Hadden looks as though he's in his early or mid-fifties and said he's been practicing for 25+ years. He said there's a 50 - 70% chance that Dr. Holden will help me deliver versus one of the other doctors.

I assumed this visit would be a handshake and brief conversation, but for each visit from now on (roughly every two weeks), I'll get a pregnancy checkup including urine test, weight, vitals and monitoring of the the baby's heartbeat.

The nurse found the Bean's heartbeat low on my belly on the left side, but as soon as the monitor tracked the heartbeat, the baby shifted and we couldn't hear it anymore. She moved the monitor and found the heartbeat again, but the Bean shifted and heartbeat went away again. Finally, she trained it near the center and we heard the heartbeat for several seconds. We both laughed. The nurse said she hasn't seen a baby shy away from the monitor in a long time -- the monitor makes a loud crackling noise, and the Bean doesn't like it.

Dr. Hadden measured my abdomen from pubic bone to fundus (top of uterus) and said I'm tracking at 32 weeks, in line with the other measurements taken over the past couple of months confirming mid-June for the due date. He felt my abdomen and said he could feel the Bean's head down near my pubic bone and back/butt up and to my right, all of which is normal.

His only warning to me at the appointment was to try not to gain any more weight. He said "Anything over 35 pounds is yours to keep" (meaning it will be harder to lose after the baby is born) and there's also a risk that if I gain more weight the baby will also get bigger, creating a harder labor situation. I'm embarrassed to write about this today, but am trying to be honest for the journal.

Attached is a picture from about 3 weeks ago (week 28)... [Demi Moore/Vanity Fair copy cat shot - Take 2]

6-Month Checkup (Wednesday, Feb 28th, 2007)

25 weeks

Weight: 160 pounds (!)

Vitals: 110/60

Bean: 132 beats/minute

Visit went quickly. I took a sugar test -- will get results next Wednesday. Doctor said he thinks my risk of gestational diabetes is low, and although I'm heavier than I've ever been, he said I'm within 25 pounds of my original weight, and has no worries. I'm ok to travel to San Jose in March.

Bean's heartbeat was 132 and my blood pressure is low, both of which are positive.

Next visit is in April, and I'll get a shot of Rhogam (becuase of potential differences in my blood type vs Michael's). No other blood tests will be needed now until it's time to deliver. We will have one more routine ultrasound at week 36 or 38.

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Rhogam: Rh0 immunoglobulin, also called anti-Rh or anti-D immunoglobulin. An injectable blood product used to protect an Rh-positive fetus from antibodies by its Rh-negative mother. The idea underlying Rhogam is if anti-Rh antibody is given soon after delivery, it blocks the sensitization of the mother and prevents Rh disease from occurring in the woman's next Rh-positive child. Rhogam is now given routinely to Rh-negative women after pregnancies in which they carried Rh-positive fetuses to prevent the mother's immune system from reacting to the Rh-positive blood of any subsequent fetus. Rhogam was developed in the 1960s by Dr. Vincent J. Freda (1927-2003), professor of obstetrics and gynecology at Columbia University.Source: MedicalNet.com http://www.medterms.com/script/main/art.asp?articlekey=11961