A visit with Herbal Tea.

Well, today was exciting.

No, still no baby.  And no, I’m still not in labor.  But today I had reason to get dressed and leave my house: an appointment with Herbal Tea.  I had prepared myself for the usual 15 minute wham-bam-thank-you-ma’am appointment to which I’ve become accustomed.  I decided that I was going to go and see Herbal Tea, go grocery shopping afterwards, and be home in time to cook a delicious lunch.  Of course, by now I should have learned that as soon as I prepare myself for one thing something else happens. 

To begin with, Herbal Tea seemed to be in an exceptionally good mood.  She greeted me with a wide smile, and a reminder that today’s appointment was going to be featuring an internal exam.  While I was glad that one of us was enthusiastic about this, I could think of about thirty things that I would rather be doing than getting up close and personal with Herbal Tea. 

After reminding me about the internal exam, Herbal Tea left me in the warm hands of the student midwife.  She had been tasked with instructing me in natural methods of labor induction, which meant trying to look comfortable as she suggested methods such as “making love” with Sea.  I had read somewhere that sperm was a key ingredient in the effectiveness of this strategy (not heterosexism: biology/chemistry), which I asked her about.  She stumbled through a response about how sperm was helpful but not the only useful component before moving on– with evident relief– to other strategies. 

Herbal Tea reappeared just as we finished discussing spicy foods.  The student midwife, followed by Herbal Tea, felt my stomach and listened to Bingo’s heartbeat from various points and angles.  They looked at each other.  “What?”, I asked.  “The baby isn’t breech again, is it?”  They paused.  Herbal Tea smiled her widest, most reassuring smile.  “I’m not sure.  It’s hard to tell.  Your baby may still just have a bony bum.  Let’s see what we can feel from inside.” 

Having just been told that Bingo might be breech, again, I was left to strip from the waist down.  I lay on the exam table, oddly sandwiched between an absorbant medical pad and a purple cloth with a floral pattern that served as a drape.  As Herbal Tea approached, snapping a rubber glove over her hand, her only words were, “Oh, baby.”  (I believe she was talking to Bingo, but still.)

When I had been told that I would be having an internal exam, I imagined the variety that usually come with a pap test: a quick feel, nothing terrible.  Instead, Herbal Tea seemed to be attempting to get her entire arm into my uterus.  “Relax“, she told me, “I can tell that this is making you anxious”.  The exam was actually not making me anxious.  The thought that Bingo might be breech again, that we might be going headfirst (or, rather, butt-first) back into the world of inversions, inductions, c-sections, was making me nervous.  The exam wasn’t making me nervous, it just hurt.  The reason for this discomfort became clear as she removed her hand, saying in her permanently cheerful voice– the voice of a slightly overenthusiastic kindergarten teacher sharing a new book with the class– “I had a fingertip through your cervix!  Look, you can see the bloody show!”  I can’t actually convey how disturbing this moment was, but please trust that the image of Herbal Tea smilingly showing off the bloodied tips of her fingers may never escape me. 

I should consider myself lucky, however: I only escaped a full stretch and sweep (which I’ve heard is about as pleasant as it sounds) because even after the internal exam, Herbal Tea wasn’t sure if what she was feeling was a head or a bum.  She was nervous enough about this uncertainty that she– the least clinical of the midwives I’ve met– asked if I would be available for an ultrasound: immediately.  Which is how I found myself back at the ultrasound clinic, torn away from my initial plans of a leisurely lunch.  The ultrasound clinic at 11am on a Tuesday morning is a very different ultrasound clinic from the one I’m used to visiting after work hours.  While the afternoon ultrasound clinic is filled with nervous pregnant people and their partners, the 11am one seemed to be exclusively visited by older Greek couples.  Old men served as translators between their wives and the receptionists, pointing out where forms needed to be signed.  A woman complained loudly on her cellphone about how waiting for a mammogram was a waste of time.  And I sat uncomfortably among them, waiting to find out what our contortionist fetus/bumhead/Bingo was up to now. 

I won’t leave you in suspense: Bingo is, thankfully, head down.  It would appear that our fetus does, in fact, have a bony bum and is also determined to give both parents heart failure before being born.  As for when Bingo will be born: who knows?  Despite the excitement of today, Bingo is still firmly in-utero.  Though 11-12-13 would have been an awesome birthday, I’m fine with Bingo staying put for now.  If the kid can cause so much trouble now, just imagine what it will get up to with a little more time and space to roam.

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.

A dissection of the anatomy scan.

After watching other people’s pregnancy announcements appear on Facebook for the last several months—with due dates further and further after ours— Sea and I counted down from three and posted our own.  I changed my cover image to three pairs of shoes and updated my status.  Sea posted a picture from Friday’s ultrasound.

Friday was the big 20 week anatomy scan: the first ultrasound we had had in seven weeks, and possibly the last one of the pregnancy.  Sea and I had both booked the afternoon off, and it felt strangely like being on vacation.  It was sunny and warm.  We went to one of our favourite restaurants for lunch.  We visited the library.  I drank my body weight in water, as required by the ultrasound clinic.  And then wandered into a small, beige office to see Bingo.

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The twenty-ninth/first ultrasound.

Sea’s neat writing on the calendar marked today’s big event:

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This morning was the first ultrasound.

Confession: I had spent most of yesterday terrified, convinced that I was going to see blood every time I went to the bathroom, worried that we wouldn’t see anything today.  But this morning I woke up less afraid and more excited.  We had breakfast, packed up the holy water, and headed out the door.

We were called in for the ultrasound quickly, by one of the ultrasound technicians I rarely see.  The room was the same one where I had had my first Clinic One ultrasound, months ago.  Under the dim lights the piles of paper sheets and endless baby pictures taped to the walls looked the same, only now the ultrasound technician was smiling and Sea was coming to sit in the chair beside the table.  I quickly took a sip of the holy water and went to lie down.  The ultrasound technician found the sac and, smiling and making approving noises, began to take measurements.  A couple of minutes later she turned the screen towards me and Sea: she pointed out the yolk sac, the embryo and, then, the beating heart.  I may have said “wow”.  I may not have said anything.  I don’t remember: all I remember is that pulsing dot on the screen.  Too quickly she turned the screen back towards her and finished the measurements.  As I sat up, I told her that we had wondered about twins given the high beta numbers and that, honestly, I was relieved to see just the one overachieving embryo.  “Hmm, let me take another look”, she responded, practically shoving me back down on to the table.  She did another scan of my uterus, but the embryo remained a lone wolf.

As I pulled my pants back on and Sea and I turned to leave the technician pushed a printout into our hands: “Here, take your baby.”

After that we met with the fourth doctor, Dr. Text having decided not to show up to work today.  The fourth doctor seems somehow less competent in comparison to the bored professionalism of the others, and I watched skeptically as he fiddled with the paper due date calculator on his desk.  According to the fourth doctor, we’re due on November 10th (though all calculators I’ve used say the 11th).  We’re to come back in a week for another ultrasound, and then for another two weeks after that.  NT scan at 12 weeks and then a referral to an OB.  I told the fourth doctor that I would be seeing my own doctor next week, and that we hadn’t yet decided between an OB and a midwife.  He took this in stride and sent us on our way with a quick congratulations and instructions to get another blood test to check my TSH levels.

The woman taking my blood asked me if I was a Catholic and talked about Sunday mass, while cheerfully taking blood from the back of my hand.  Then we were done.  We left Clinic One and headed to our respective offices, that first photo tucked neatly into the front pocket of Sea’s purse.

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Total Ultrasound Count: 29/1