Yesterday, John and I went in for another ultrasound and appointment with both the perinatologist and our OB. Everything looked good on the ultrasound - Bumble seems to be thriving, her blood flow looked good, and she was practicing her boxing. I had been concerned that at her last growth ultrasound, her belly was measuring a week behind, but the peri did a quick scan of it yesterday. It was measuring a couple of days ahead, so good news there too. We'll have our last growth scan next Tuesday to try to figure out how much the tiny girl will weigh when she meets the outside world.
As the big day gets closer, more and more questions keep popping into my head. One of them was about the amnio. I wasn't really sure what to expect with this - how it would feel, how long it would take, where it would be done, and what to expect afterwards. The peri walked us through all of this - she's had an amnio before, so she was able to tell me what to expect from that perspective too. She scanned my belly to look at the entire placenta and try to figure out where the amnio could be performed. She found a little place at the very top of my uterus, just beside my rib, that she thought would be a good place to do it.
We then discussed the plan for the amnio and what would happen afterwards. Because of the risk of triggering labor or contractions, which could very well lead to more bleeding, she was not comfortable with me having the procedure at one hospital and then traveling to the other hospital to be monitored. We were thankful that she switched her schedule around so that the anmio could be done at our regular office/hospital, and then we would be able to go directly to labor & delivery for monitoring. This was one of our big questions/concerns for the day, so we felt much better about not having to travel between hospitals.
We then headed over to meet with our OB. The peri had gone over in advance to discuss the ultrasound findings so that everyone would be on the same page. Once we got back into the exam room, we started to have a sense that anxieties were rising. Our OB's office must be right next to the exam room, because we could hear the two of them talking for a bit of time. Our OB came in, and we immediately knew that it wouldn't be a normal appointment. I'm not sure why no one knew this before, but my placenta situation seems to be a particularly complicated one. Not only is it extremely vascular, particularly down around my cervix, it is also anterior, extending pretty much over the entire front of my uterus. Which is why the amnio has to be done way up next to my rib. The major concern is how to most safely deliver the baby. It seems that there is no way to make an incision to get the baby out without cutting through my placenta. Yes, the placenta that is basically just a very large bundle of blood vessels. Yes, the placenta that is the baby's lifeline, her entire blood supply.
So, this is where John and I start majorly freaking out.
The conversation continued. She talked about how it would be a complicated surgery, and wanted to prepare us for how tense things could be in the operating room. She warned us that there would be a lot of blood. She described the precautions that would be taken - extra surgeons and nurses, a blood supply in case I need a transfusion, and a team of neonatal staff to take care of the baby. She said that the surgery would have to happen very quickly to get the baby out as fast as possible and to remove my placenta in order to stop the bleeding. She mentioned the chance of me needing a hysterectomy, although she didn't feel like this was a big risk. An additional complication of placenta previa is placenta accreta, where the placenta attaches itself too deeply into the uterine wall, causing difficulty in removal. Thankfully, from the ultrasound exam, it doesn't look like this will be a problem for us, but it is hard to know until they actually get in there and see the situation first-hand.
During the conversation, it seemed like most of the risk was to me, and not to the baby, since our OB seemed pretty confident that they could get the baby out pretty quickly. We talked about my continued bed rest and the possibility of me having the baby sooner than our scheduled date. If I have another bleed, they will go ahead and deliver her, and from the looks of my placenta, they seemed to think another bleed was pretty likely (I think because of how vascular my placenta is around my cervix and because of the increasing pressure on the placenta as the baby gets larger). We talked about a plan for getting me to the hospital - whether we should drive ourselves or call an ambulance. Since we live less than 10 minutes from the hospital, it seems that unless I'm having a major hemorrhage, the best course of action would be for us to drive to the hospital directly.
John and I left the appointment dazed and anxious. When we got home, the fear set in.
I think I was too overwhelmed with all of the new information to really process it until we go home. Right now, the biggest emotion I'm feeling is fear. Fear that after everything, something will happen to the baby during delivery. Fear that I'll die during the surgery. Fear of how everything will be handled should I have to have an emergency c-section before our scheduled date.I slept fitfully last night, with all kinds of scenarios running through my restless mind and a long list of questions for the doctor developing in my head.
I'm also feeling a lot of frustration and anger. I feel like every time we go to the doctor, there is more information that changes the situation, making it more complicated and stressful. I feel frustrated that every time we come up with a plan to help us feel more empowered in our particular situation, to help us feel more connected to our daughter's entry into the world as a birth and not just a medical procedure, something changes, and we are thrown off-center, having to start all over again. I am really torn between wanting to get this over already and knowing that every day that Bumble is able to continue growing inside of me will help her be stronger and more ready to face the world on her own. But I'm seriously wondering how I'll get through the next two weeks.
I've been working on another post about how I've been feeling about having a cesarean birth, about the grief I've been feeling about not being able to deliver my daughter vaginally, about the lack of resources I've found to help me process the feelings I'm having. But really, now I'm feeling so overwhelmed with figuring out how to keep my daughter and me safe until and during delivery, that none of those other things really seem to matter any more. I'm sure I'll need to process them more later, but for now, it seems like there are more pressing matters requiring my mental and emotional energy.
I feel like John and I are truly learning lessons on adaptability, on how nothing is ever truly certain, on drawing on our inner strength to carry us through these stressful and uncertain times. But for now, I'm just tired and anxious, and more than ready to have my daughter safely in my arms so we can begin the next chapter of our lives together.
Today, I'm putting in a call to our OB to try to get some of our questions answered, so that we can start to create some peace of mind as we anticipate our daughter's arrival.