Magic baby.

No, we don’t have a baby yet.

My lack of update following our impromptu appointment with the OB/GYN on Tuesday is purely a result of my computer having experienced an utter collapse a week ago.  Though the computer has not yet been repaired, I’ve come to the decision that blogging from work is an excellent use of my lunch hour.  (Food is optional at 37ish weeks pregnant, right?)

So, Tuesday.

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Flippin’ Bingo.

Let’s begin with a bit of history.

As you might remember, six weeks ago the hands of Diet Coke and the student midwife identified the possibility that Bingo was breech.  At 30 weeks, this wasn’t a very big deal– there was still plenty of time for backflips and handstands.

Two weeks later, as the student midwife looked on, Herbal Tea reassured me that Bingo was now head down.

Somewhere around 34 weeks, I went for the then bi-weekly visit to the clinic and met my tertiary midwife.  Based on the scheduling system of the midwifery clinic, it was very unlikely that this midwife would actually have anything to do with the labor or birth of Bingo.  But I met her anyways, just in case.  The tertiary midwife (let’s call her Skim Milk) was friendly, queer, and a good middle ground between Diet Coke’s fast pace and Herbal Tea’s uncanny calm.  As I lay down for the exam, we talked about sperm donors and gay kids’ books.  As the ever diligent student midwife looked on, Skim Milk felt my stomach.  “Hmm”, she said.  She felt some more.  “Your baby has a bony head and a bony bum.  I can’t entirely tell which is which.”  Oh.  Skim Milk explained that she was fairly sure that Bingo wasn’t breech, but that she didn’t want to have missed anything and I should come back a week later to see Diet Coke just in case.

So last Tuesday I did go back to see Diet Coke, just in case.  She felt my stomach carefully, hands cupped around the bump just below my ribcage.  Like Skim Milk, she commented on the difficult task of discerning Bingo’s head from Bingo’s bum, as I made a mental note to mock Bingo for this prenatal quirk frequently (“Bumhead!”).  Then Diet Coke sighed, her tone gentler and slower, “So, I’m about 80% sure that the baby is breech.”  She examined my face for any reaction.  “Maybe 70%.  I want to refer you for an ultrasound to make sure, one way or the other.”

The thing is, despite a healthy dose of sarcasm, I’m an optimist at heart.  So even while two out of three midwives agreed that Bingo was probably breech, I had decided that Herbal Tea was the voice of reason.  There was no way that Bingo was breech!  I half-listened as Diet Coke talked about the decreasing possibility of Bingo flipping, and cheerfully called Sea as I left the appointment to tell her that we were going to get a bonus ultrasound!  Covered by insurance!  Score!

24 hours later I was lying on a crinkling sheet of paper at the clinic where I had, over a year ago, had my very first ultrasound ever.  Sea had been relegated to the waiting room again, and I was sulking a little.  But the ultrasound technician had promised to let her in after the initial scan was done so that we could both see Bingo in action.  I tried to be patient as the ultrasound technician worked silently, screen tipped away from me.  Finally I asked, “So, which way is the baby facing?”  And, despite the large sign on the wall announcing that ultrasound technicians could not discuss the results of the scan, she announced matter-of-factly that Bingo was breech.  Definitely breech.  I had been so certain that Bingo wasn’t breech (Herbal Tea had said) that it took me a moment to process this information.  “You’re quiet.” the ultrasound technician commented, which was slightly ironic considering the fact that this was her third sentence of the entire appointment.  “Oh,” I replied, “I’m trying not to swear.”  Sea was allowed into the room, and we both watched Bingo’s hands and lips move on the screen.  This, along with two grainy printouts, was the only consolation offered by the appointment.

ImageAs we left the appointment, Sea asked me how I was feeling.  I was less cheerful than before, certainly, but that could also have had to do with the drying ultrasound gel uncomfortably adhering my shirt to my skin.  I decided that I was fine– that one of our now three midwives could surely make a fetus flip.  The worst that was likely to happen, I reasoned, was a suggestion of yoga, acupuncture, massage, or something equally benevolent.

I’ve spent the last six days in this state of intentionally ignorant bliss.  Sea, on the other hand, (who could be described either as a realist or a pessimist) went home and immediately read everything the internet could provide about breech births an external cephalic versions.

Which brings us to today’s appointment with Diet Coke, which both Sea and I attended.  After commenting briefly on my iron levels (still “very low” but improving!), Diet Coke pulled out the paperwork sent by the ultrasound clinic.  Like any well-trained medical practioner, she started with the good: Bingo is a good size, healthy, with a well-located placenta.  She then moved smoothly into the bad: not only is Bingo breech, Bingo is twisted into an odd position.  One leg is pulled upwards in the traditional frank breech appearance, the other is angled downward.  The chances of Bingo turning from this position with low-level intervention are very, very slim.  Natural birth from this position is potentially unsafe.  Our two remaining options are a scheduled c-section or a referral to a doctor for an attempted external cephalic version (ECV).

While avoiding Sea’s frantic Googling, I had read an article or two about ECV and had imagined some sort of deep tissue massage: maybe not pleasant, but certainly not invasive.  I had assumed that the ECV would either work or not (though, of course, I had really assumed that it would work) and that we could then wait out the rest of the pregnancy in peace.  Not so.  The most reputable doctor who performs ECV in our area does so with the patient not only fully monitored, but with an epidural administered.  If the ECV works (a 50-70% chance), he immediately induces labor so that the baby doesn’t have the opportunity to flip again.  if the ECV doesn’t work and the baby is in distress, he performs an emergency c-section.  If the ECV doesn’t work and the baby isn’t in distress, a c-section is scheduled for a later date– but no later than 39 weeks.  If you’re following along, that means the available possibilities (not even really options, as we’re not the ones doing the choosing) are:

1)  Successful ECV in the next couple of weeks, followed by immediate induction.

2) Unsuccessful ECV in the next couple of weeks, followed by emergency c-section.

3) Scheduled c-section.

None of these options include a fully natural labor and birth, and none of them include carrying to 40 weeks.  While Sea had read enough of Google to be expecting something like this, I was almost completely taken by surprise.  I was almost, barely, keeping calm when Diet Coke suggested that I also stop biking to reduce the risk of Bingo engaging too deeply in my pelvis.  “I’m going to cry”, I said.  And I did.

It’s not that I had envisioned birth in the way that Herbal Tea does.  I hadn’t imagined candles, warm water, soothing music.  As I’ve mentioned in other posts, Sea and I had decided that our birth plan was to have a baby.  Safely.  Probably in the hospital.  But on some level I also imagined having more choice, more freedom, more unpredictability.  I had imagined not knowing the date of Bingo’s birth in advance, going into labor, figuring out what I needed and wanted as the time came.  Now, if I go into labor we’re supposed to immediately go to the hospital for a c-section– telling everybody in our way that Bingo is breech.  I hadn’t imagined much about Bingo’s birth, but what I had imagined wasn’t this.

Poor Sea watched bewildered as I sat crying on the neatly made bed/exam table in Diet Coke’s office.  She reminded me that Bingo is healthy and safe, and that we’ll have our baby soon.  Diet Coke did the same, her voice now almost as gentle and calm as Herbal Tea’s.  “Birth is just the doorway,” she said, “Some people get to go through it smoothly, others bump their heads.  But the rest of your lives is the journey: the birth is just the door.”

And it looks like, one way or another, we’re getting close to heading through it.

Hmm…

“Hmm…”  Herbal Tea nodded, head tilted slightly to one side.

Jeans still pulled uncomfortably low around my waist from the fundal height measurement, I sat across from her and thought, “I know that hmm…”  That exhale of breath through closed lips, the head tilt, the non-committal nodding: they form the exact expression that I utilize in my work on a regular basis to express non-judgement, most often at the times when I am judging somebody the most.

Despite connecting with Herbal Tea over lesbian prison drama during our last meeting, this appointment was not going well.  Herbal Tea had begun by pointedly noting that Sea wasn’t there, commenting that she “must be very busy with work”.  She had then asked if I had spoken to my mother about my birth, or my sibling’s birth.  I had answered honestly and unthinkingly, telling her that my mother had told me stories, but that I didn’t want to talk about birth with my mother.  Ever.  Herbal Tea’s voice, still mild, expressed shock.  Why wouldn’t I want to talk about birth with my mother?  I tried to backtrack, rushing out a story about the difficulties my mother had experienced in an understaffed hospital when my sibling was born on a holiday.   “Oh, my son was born on the same holiday.” Herbal Tea replied.  “Except it was a home birth.  It was magical.”  Oh.

The “hmm…” happened a few minutes later, when Herbal Tea asked if Sea and I had yet attended one of the clinic’s home birth seminars.  No, I explained, we had decided on a hospital birth.  “Hmm…” Herbal Tea nodded, head tilted slightly towards one side.  And though I’m intimately familiar with the judgement of that “hmm…”, Herbal Tea refrained from saying anything else.  I know that a hospital birth in a single bed sandwiched between the room’s linoleum floor and halogen lights isn’t what Herbal Tea would have chosen, but for Sea and me there is more comfort in this strange and sterile environment than in the warmth of our own living room.  In different ways, Sea and I are both anxious people by nature, and in this very unfamiliar thing we’ve decided we would rather be surrounded by the people and technologies equipped to deal with emergency than by our cats.  So I responded to Herbal Tea with a head tilt and nod of my own, and we moved on.

We’re now at 32 weeks (now 32.5).  Bingo is measuring right on track.  Even more importantly, Bingo is now head down.  And I am sure that, just to spite both me and Herbal Tea, Bingo will be born somewhere else entirely.  On my office floor, maybe.  Or in a taxi.  Or on the floor of Herbal Tea’s office as she tilts her head to the side and nods.

Hmm…

Heads up, Bingo!

Yesterday I went to visit my friend, Diet Coke.  The visit marked the beginning of appointments every two weeks, as Bingo creeps closer to graduation.

Having seen Herbal Tea just two weeks ago, and the most interesting feature of that appointment  having been HT’s enthusiasm for Orange is the New Black, I naively wondered what there would possibly be to talk about only two weeks later.

As I sat in the waiting room, I heard the student midwife being prepped by Diet Coke in the background, “This is the patient with very low iron levels.”.  Notoriety, oh good!  The student appeared moments later, smiling nervously and grasping a clipboard with paperwork that– no doubt– referred to my hemoglobin.  I was ushered back into an office that I hadn’t been into before, the exam table made up to look like the bed in a slightly worn, but warm, B&B and pictures of babies and nursing women on the walls.  The student asked me about blood tests, iron supplements, and birth plans before asking me to lie down on the table/B&B bed for the physical exam.

I reminded myself of the fact that she was a student as she measured my fundal height beginning somewhere near my vagina, and again as she struggled to find Bingo’s heartbeat (I wasn’t worried, having felt Bingo kicking minutes earlier).  In general she was nice, competent, and she had warm hands: all things that I appreciate.

I suspect Diet Coke had been listening through the door: she appeared moments after the student had finished her exam.  She asked the same questions, repeated the fundal measurement from a more comfortable location, and found Bingo’s heartbeat within seconds.  Then, feeling at my belly, she paused.  “Huh”, she said.   She poked at my belly some more, bouncing both hands just below my ribcage.  “Huh”, she repeated: “I feel a nice, bouncy head here.”.  Turning to the student she directed, “Feel this.”  Four hands were now pushing on my stomach: “No, here.  Over here.  Feel that?  That’s the head.  Up here.”  Diet Coke looked at me over my belly, “Thanks for being a teachable moment.”

Apparently, Bingo’s head is somewhere around my rib cage and Bingo’s feet are somewhere around my pelvis*.  As Sea explained it later, Bingo is upside down. Upside down in fetus-land means that Bingo is right side up.  At 30 weeks, this isn’t totally uncommon, but it isn’t typical either.  Bingo has four weeks to do a headstand before we’re sent in for an ultrasound to confirm the upside down/right side up position.  If Bingo refuses to turn (please don’t be a jerk, Bingo), then they start trying to move Bingo manually.  I’m not totally sure what this involves, but it doesn’t sound terribly comfortable.  So get to work and put your head down, Bingo!

*I’m a little confused about this positioning, as I feel Bingo’s movements the most on my right side under my ribs.  Either Bingo’s bum feels like a head and the midwife is wrong, or the kid is just really into fist pumping.

I may have underestimated Herbal Tea.

After taking my blood pressure, measuring fundal height, and listening to Bingo’s heartbeat, Herbal Tea asked me if I had been watching Orange is the New Black.  She’s totally hooked, she explained.

I may have underestimated her.

(And, yes, Sea and I have been watching it.  We may not talk to Bingo a lot, read to Bingo, or play Bingo music… but gosh darn it, that kid is going to get an early exposure to lesbian prison drama.)

Iron woman.

Returned from my travels to find a message from Diet Coke, the midwife: “Hi, just calling to let you know that the results of your glucose text were awesome.”  Take that, risk factors and doubters!  (I’m looking at Sea, who has frequently raised a judgmental eyebrow at my chocolate consumption over the past six months.)

Of course, a greeting like that is bound to come with a “but…”.  In this case, the but involved words like “hemoglobin”, “anemia”, “supplementation” and ended with Diet Coke cheerily saying, “I look forward to chatting with you about iron rich foods!”

I’m currently waiting for Herbal Tea to return my call (Diet Coke is on vacation) and tell me what this unyielding vegetarian should do to improve her iron levels.  I also welcome your expert opinions (bonus points if they involve chocolate).  I’ll work on becoming better acquainted with spinach while I wait.

Partner’s Post: Diet Coke and Herbal Tea – A Tale of Two Midwives

If Clinic One is the Costco of fertility clinics, then the midwife clinic to which we transferred after is the small town general store. A general store of the sort that sit, chipped red paint fading, at the fork of two dirt roads cut through a thick wall of evergreens 30 minutes from the nearest sign of modern civilization. The sort of place that offers everything from fishing bait and firewood to quarts of milk and Band Aids, with a rusted, mud-splattered pickup parked outside, and its interior wood paneled walls adorned with kitschy metal roosters and retired license plates. Continue reading