pcos - TTC #1 - irregular cycle

[Little_Bits]

You're past 24 weeks - horray!! And you've already felt Braxton Hicks, which is a great way for your body to gear up for labour (even if you have a long way to go). That's terrific that you finish on June 17th... me too! That's only 15 more days of real work, even without the bank holiday. You can do anything for 15 days! And soon you'll have the time (and hopefully energy) to do that fun bit of shopping. My mother-in-law came today for a visit with even more baby clothes, and now we have way way WAY more than we need of little knitted cardigans. I'm so glad your DH is now there with you to stay and you can start nesting. When is it you are moving into the larger flat? I know it can be hard to order anything big because you'll be moving! We just put the cot together yesterday and it was challenging for me to help because of how awkward I am. The nursery is now done (I think?) except for a bit of artwork I am still working on. I bet you are excited to get working on that too. Are you going to go with a theme? Or have other thoughts? How is your name search going?

What a relief to think that you will be able to give birth vaginally. The recovery time is so much quicker! Its great you are going to be right next to the OR just in case. Has the NCT class gone through the different types of pain relief choices or relaxation techniques yet? Do you have any thoughts of a method you'd like to follow? I'm glad the other couples are so kind as well, my NCT group chats on WhatsApp on a near daily basis. We've already had our first birth (a scheduled early c-section because of complications) and now the rest of us are just waiting. It's great to have people who are in the same stage as you (eve if they aren't carrying twins!).

I'm glad you're feeling alright and still finding the energy to stretch and move. I'm finding the evenings quite difficult at the moment and just getting through the day at work is an achievement. I'm also really happy to hear you're feeling so much movement. I know from my side I feel very reassured whenever the baby is active as I know they're there and okay. I hope your trip to Paris went okay and you felt good throughout the trip. Did you just take the chunnel? I think it's probably a wise choice to skip the conference in July, that is getting very close to the end of your pregnancy and you probably won't want to be so far from home just in case. How exciting about your babymoon! I can't wait to hear all about it.

My baby shower was lovely, with sweet little presents, delicious foods and kind friends. I'd actually love to return to work at this school, but I am also looking forward to not having to go back to work if I choose not to. I think best case scenario would be to go back as a substitute when needed and then wait for a maternity cover position once Wriggles is a little older (maybe 2?) and ready to go to nursery. I think I'd love just being a mommy for a while!

Well another week is upon us, I hope yours goes smoothly and I can't wait to hear about your scan on Tuesday!

[inthemetro]

I'm glad you're so close to finishing work. And I hear you on every day being an achievement, particularly with how demanding your job is. You're so, so close to being done--and to meeting Wriggles. I'm glad you got the cot up (and I'm impressed you did it at all--both DH and I are totally mechanically clueless) and that you got a shopping trip in with your MIL. That does sound like fun. And I hate to ask, but any movement on the name front? I'm rooting for you.

On my end, unfortunately, we got terrible news at today's appointment. She's still growing, and she's kept her growth curve since last time (which is good). But what we had hoped (that she's just genetically small) turns out not to be the case: her placenta is weakening. The ultrasound showed baby girl's placenta isn't working like it should be. The doctor thinks the chances of her making it to term or of becoming a 5 lb baby are fairly remote. The problem is there's nothing really to do about placental failure (which is probably what will happen at some point, though we don't know when) except deliver the baby. But that's out of the question now: she's teensy, and only clocks in at a little over a pound, so even if she were a singleton delivering her now (or within the next few weeks) would be out of the question.

Though of course she's not a singleton, which raises a whole other dimension: her brother. Baby boy is doing terrific. He's still big and growing strong as ever. His placenta looks great, and because they're di-di and they have separate placentas her problems won't affect his growth or development at all. But if she's born, he has to be born too (you can't take out one twin and leave the other in), which means that giving birth extremely early would put him at all the risks that extreme prematurity would entail. The doctor warned us that the time may come where we could have to face awful choices of pitting the interests of one baby against the other's: at some point staying in the womb might mean baby girl would die, but being born that early would make baby boy face terrible risks.

The other terrible scenario is the real possibility that we may lose her in the womb. The doctor was loath to put this in statistic terms, but he thinks there's ultimately around a 50/50 chance that she won't survive. If she does pass away, he stressed that baby boy should still be fine.

The only thing that's certain is that right now there's nothing to do but wait. Giving birth is out of the question for now (even disregarding the welfare of her brother, she's better off inside), and wouldn't really start being a serious option for at least another month or so, regardless of how she's doing. I'm going to continue to get monitored anyway, and I have another detailed scan booked for June 14th, not because it would lead to any action (giving birth that early would be out of the question--no matter what, it'd be the wrong choice for both babies), but just so we can know how they're doing. Both DH and I definitely want to know how things are going. Monitoring will help determine when she drops off her growth curve and when her placenta is failing her entirely, though there is at least some hope that she can continue hugging the bottom of her growth curve for a while, which the doctor thinks is also a possibility (it's impossible to know at this point how the timing of all these things work). And the calculation of what to do changes rapidly as time goes on, so that if baby girl can hold on long enough being born won't be so awful for baby boy. One silver lining is that baby boy is so big. He's over the 95th percentile, and clocked in at 860 grams (which is fairly sizable for his gestational age). The hope is that his size will help him if he does have to be born earlier than he should be.

I was hoping against hope there'd be some other course of action, that I could eat more or gain more weight or go on bedrest, and none of those things would do baby girl any good. (In fact, bed rest would be actively bad--I shouldn't exercise, but if I don't move around and do basic daily stuff I'm at high risk of a blood clot, which would be terrible for all three of us). Nothing caused her placental issues besides the fact it is more common in twin pregnancies.

Anyway, I'm sorry for the enormously depressing posting. It's all still sinking in, and DH and I are veering between crushed and hopeful. Our daughter is so much a part of our family already, you know? And I feel her kicking around and feel (maybe stupidly) that she's a fighter. It's tough to balance between hope and also preparing ourselves for the worst. I think right now, besides hoping for baby girl's health every time she kicks, I just hope we don't have to make choices where we have to balance their interests--I love them both so much, and don't want either endangered, and really don't want us to be the ones to make that call.

We're still going to go to Paris this weekend for the wedding--seems like there's no point in not doing so--but everything else this summer is definitely up in the air. I'll ask at the appointment on on the 14th, but I suspect canceling the baby moon is a good idea. And in the meantime we can just be hopeful, but we're telling close friends and family to make sure they are in the loop given that there are so many different directions this could go (from incredible tragedy to a much greater likelihood of an early birth, one or both babies facing serious NICU time, etc.).

I think your post-birth plans make a lot of sense. It's nice to be able to choose when to go back on your own terms, based on getting to enjoy Wriggles and depending on when you are ready to give Wriggles a sibling. And I hear you on wanting to enjoy motherhood for a while. Yeek. Giving birth seems really far away. But I hope you're feeling good, and that things are looking up on your end.

[Little_Bits]

Oh my goodness, my heart is completely breaking for you: I know that baby girl is already your daughter and you are already her mama and that she is such a big part of your family. I can't even imagine how you are feeling right now, although I'm glad to hear you've still got some hope and some chance. I also hope that baby girl is a fighter and that she will keep fighting and hanging on. It's all so terrifying isn't it? That we have so many medical advances and yet are sometimes so so helpless. How terrible that there is nothing you can do but wait, and wait and wait some more. I am so sorry, and I am sending big hugs and lots of positive thoughts your way. Please keep me updated, I want to be here for you if you need it - venting, grumbling, tears, whatever helps. I'm so grateful that your DH is back with you to help in this difficult time and you've made a wise choice to keep a few people in the loop so they can be there to support you. You'll need all the support you can get. It's just terrible, no one should have to go through this!

I don't feel like I have anything to complain about,
The days are long and Wriggles has made my stomach a maze of stretch marks but s/he is there and kicking. We've settled on names: William for a boy and Eleanor for a girl. Backup names are Benjamin for a boy and Abigail for a girl - still working on middle names, but at least we'll know what to call them.

Oh inthemetro, I am just so so so sorry. I wish there was something I could do for you, but just know I'm here if you need me. I think you are smart in cancelling the babymoon and after the Paris trip staying close to home to be monitored just in case. I know waiting for your next scan is going to be torture, so I hope you have found other nice things to treat yourself to - like baths and once cream and snuggles!

It's late already so I'm heading to bed, but I'll be checking in every day just in case!

[inthemetro]

Thanks so much for your note and your solidarity, Little Bits. It's been a bit of a whirlwind of emotions, but I'm really lucky that DH and I have each other. And we're trying to stay positive--baby girl is kicking and holding in there and, at least for now, still growing, her fluid levels are still great, etc., so things haven't gotten really bad for her yet and we can hope things stay as they are for now. We're hopeful that she makes it through. I think to some extent we just have to take it one step at a time, and see how things go. For right now it seems like doing any kind of preparation doesn't make a lot of sense--after all, even if they are born very early, we'll have a few weeks of NICU time to take care of things and learn about how to care for them and all of that, and I've decided it's not really worth reading up on risks and all the scary parts given that we just have no idea what the future will look like right now. I am grateful for how many medical advances we have, for sure, and I know there are a lot of babies born premature (particularly in the 32-4 week range) who do extraordinarily well in the long term. There are also a lot of happy endings even with growth restricted babies.

As for the scans: it's definitely torture waiting, but I appreciated that the doctor discussed with us how much monitoring we want to do right now. The problem is, of course, that no matter what happens on the scan there's nothing we can do--no matter what (short of something unforeseen and catastrophic for all of us, e.g. preeclampsia), giving birth in the next few weeks is off the table. So the question of monitoring is a bit more about where we want to be emotionally. Later on it's different because scans can help influence action, but for now it's more just about how much it will comfort us vs being a constant source of anxiety. And waiting two weeks sounded right. It's enough so it'd be a milestone so it'd really be something to celebrate if things hold steady, I think.

There's an element of trying to take it one week at a time and being grateful the further along we all get to move. Dh and I are already talking about how much better things will look if we get through June with her placenta giving her what she needs to keep growing. We're also lucky baby boy is thriving so well. And, as the doctor told us, we're very lucky they have two separate placentas, because things would be terrible for both of them if they didn't. We're lucky no matter what to have our beautiful baby boy, too, and I think it's healthy to keep that centered even as we're sad and anxious.

Telling people has elicited loving and really supportive response (my mom keeps sending me notes saying she loves all of us, including "our baby girl," which I really love--the babies already have a community of people who love them, and they're not even born yet). But one friend of ours warned me that I need to eat more protein and breath deeper (as if I hadn't been breathing enough? Or something?), which made me incredibly angry. I know she didn't mean to blame me for baby girl's weakening placenta, but I definitely took it that way. There's an element where I already feel guilty that she's struggling in the very place she be the safest: inside of me.

Eek, anyway, thanks for letting me rant. We're in Paris, which is nice and I hope will get our minds off of things a bit. I'm glad to hear you guys settled on names! I LOVE William and Eleanor. Classic, powerful, but really beautiful and not too common. (Also, as a sidenote, I have two students named Will this term, and they are both brilliant and lovely boys. One's an activist, the other's a rugby player, but they both are really gentle, sweet, intellectually curious boys. I know that's not that relevant to your choice, but I hope it give you even better name karma!) Both names also nickname so well, so that they are powerful names for adults but also really cute names for babies, which I really like. And your backup names are beautiful too. That's lovely.

Before we got the news about baby girl we had settled on her name. I hope it's not tempting fate in some way to share it--mostly we just call her baby girl among ourselves--but we settled on Margot. It just felt more and more right, the longer we went over it. We're not totally sure on baby boy, but we both ended up really liking an unusual, dark horse name candidate that is at least our current front runner: Rohmer. Eric Rohmer is my favorite director, and there's something about the name that just sounds wonderful to me (particularly with DH's last name), though I'm a little worried about giving baby boy a name that's so unusual. Margot isn't common, but it's as lot less uncommon than Rohmer. We haven't even really started trying to think about middle names, but I think middle names are easier anyway and can come together at the last minute if need be. First names you really need to take your time with in a way that middle names I think just kind of snap into place.

Anyway, I hope you get through the workdays okay (we're already at Thursday!) and that you make it to the weekend. And the stretch marks will fade (seems like many people's are invisible) but I'm glad Wriggles is kicking so much. That really is magical. I feel my little guys more and more, and more movements and not just kicks. It's so loving and comforting. And I hope you aren't too exhausted and that you're gearing up for a restful weekend!

[jshopeful]

Ladies!! So good catching up with progress!!

[Little_Bits]

Hey inthemetro, I hope everything on your side is holding steady. Have there been any changes? It's so wonderful that you are staying positive. It's good to hear that baby girl is still kicking and her fluid levels are good. If there is nothing else you can do other than take it one day at a time and cherish her each moment. I think you are smart not reading up on all the horror stories out there, they will do nothing besides get you even more worried and stressed which is definitely not what your body needs. It also makes sense in regards to the amount of monitoring you're getting. If it can't influence any action and won't change anything then there isn't much of a point.

I definitely get how frustrating and angry a comment like your friend can make you. It brings me back to when I was TTC and people would tell me to "relax" and just "let it happen" when what really happened was I needed medication, not relaxation! You are doing everything you can to protect and nourish your babies. These things just happen - it's life, and all we can do is cope with it. I hope that the majority of people are more sensitive. It's wonderful how supportive your mum is, especially with the sweet notes.

I hope you are enjoying a lovely weekend in Paris! We've had a heatwave up here in Scotland and I had a really wonderful weekend. Today I was REALLY nesting and I cleaned and organized all the kitchen and utility room cupboards and started a painting for Wriggles' room. I spent some lovely time sitting out in our back garden today, and yesterday it was our 6 year wedding anniversary (how time flies!) and we went out for "drinks" in town and then to see a movie. I'm really trying to make the most of our last few weeks of just being a couple and taking the time to do things together that will be just a bit harder once Wriggles makes his/her appearance.

Thanks for the positivity with our names - we aren't sharing them with anyone yet so we don't get any bad reactions but it's nice to have a second opinion. I think it's just lovely that you've named Margot already. She is a real, kicking person and now you can refer to her with her name! And Rohmer is definitely an interesting name but it sounds strong and unique at the same time. I like that even though it's uncommon, it's easy to pronounce and wouldn't confuse people. My least favourite names are the crazy spelling of normal names (like Emylieey for Emily or something!) as I think it makes everyone's lives a little bit harder. But really, it's important that the parents love the name as they will be the one calling it out over and over again.

This coming work week for me is looking good - I have a half day tomorrow and a day off Tuesday, then work as usual Wednesday-Friday. Then only one more week and I'm off! I can't wait to start maternity leave, especially with all this wonderful weather. I'm thinking good thoughts your way!

[inthemetro]

Congratulations on so many milestones, Little Bits! First, happy six year anniversary--holy cow, that's a long time. How wonderful--and it's great Wriggles is arriving to such loving and stable parents. And happy 37th week tomorrow. You'll be at term, which means whenever Wriggles wants to arrive, everything should be all set (even if it may be a few more weeks until the big day). That is wonderful, and a milestone way worth celebrating. I hope the final nesting feels good and not too overwhelming, but I'm glad it was balanced with mocktails and resting outside.

Things are stable over here. I was super achey yesterday--I felt a lot of pelvic pressure that I hadn't felt before, so I immediately called the high risk clinic. They were reassuring and, after asking a bunch of questions about symptoms of preterm labor I thankfully don't have, assured me that it's just a side effect of pregnancy and normal. And I was comforted by the fact there weren't any contractions, bloody show, etc. etc. But still, I felt both a little crazy (how can I not be anxious about everything?) and also a little relieved (okay, at least preterm labor isn't on the docket). I have my glucose test on Thursday, so it'll be great to knock that problem off the list too.

I understand about not wanting to share names--we're not telling people, either. I think it makes sense to roll out after the birth. And plus, you guys can't even know the name--since you're waiting to know the gender, you have two options anyway. The last thing we need are more judgy people!

It's a weird place to be in, besides the anxiety and sadness about how baby girl's doing, it makes it just hard to talk about or even think about the future. Though I'm really grateful for how supportive and loving everyone's been. The bad responses have been few and far between. But if you'll forgive me one more ranting: another bad response, which harks back to the ttc-days, is about what's "natural" (and one really wince-worthy friend who said if we lose baby girl that it's "natural"!!). The whole "natural" construct drives me crazy. I mean, it's natural to die of blood loss, or preeclampsia, or strep throat...what total bullshit. Or as if that makes tragedy any less terrible, somehow, is beyond me.

I felt vaguely guilty--like I was jinxing something?--telling you her name, but I like your answer that she's already a person. It's tough to be in this precarious place. We've decided to temporarily put on hold more nesting (well, besides the items where we just need one and it's kind of neutral), which makes sense (we're moving to a new flat at the end of the month anyway) but because we don't want to buy things for two babies when one may not make it and we'd be haunted even more, but we also don't want to buy things for one as if we're not rooting and hopeful for baby girl. At least we have time: if I deliver anytime soon, it'd be weeks before they come home, ample time to pull the trigger on the double stroller, etc.

I mean, for the first trimester it was all precarious, but dealing with that was easy: we just told very few people. But I figured once I was well into the second tri, and particularly with a few very good looking ultrasounds, that things were safe. We're now in this very different zone, and it's tough to know what to do in part because it seems so unprecedented, at least among people I know. I realized that DH and I don't even know anyone who's had premies, let alone pregnancies where late in the second tri (and, potentially for us, into the third) one baby's outcome is really not clear. And it's a whole other dimension having a healthy twin and a twin in jeopardy.

And I'm also appreciating some things that are easier. I think before I was pregnant, and early on in the pregnancy, the many terrifying outcomes we're facing would have been far scarier about having one or more very small babies, facing serious NICU time and all its attendant risks, etc. I think it's the same way that having a baby with a disability was scarier. Now it's just clear: we're ready for these two no matter what, whoever they are, and I'm just rooting for them both to make it. If they're born incredibly early (and, in baby girl's case at least, extremely fragile), we'll do whatever we need to do and learn whatever we need to learn to be there for them.

She's been very active, thankfully, and I'm grateful for the comfort of that. I tell myself (again, maybe not in the most scientifically-proven way) that she's already come this far, and that's got to be a good sign. And I did a little bit of limited googling--"IUGR twin success stories" was a good idea--and am staying hopeful. We're lucky work-wise that it's easy to put everything on hold for the summer, and I'm grateful for the timing, so that if I have to be admitted in the near future logistically it's all very simple. Anyway, I hope your week is going okay, and that you are enjoying the same nice weather we have down here. Congrats again on making it to term--go Wriggles!

[Little_Bits]

Hey inthemetro!
How did the glucose test go on Thursday? I'm sorry to hear about the pelvis pain, but also happy to hear that it was just normal aches and pains of pregnancy. I've had a few moments like that and midwives must be so used to that. We've never been pregnant before, how can we know what feels "normal"? I would say this is probably especially true in the high risk clinic as most women, even if they have been pregnant before might not have been with multiples or whatever other thing has brought them to the high risk clinic.

I got really angry when I read that last comment from an insensitive person that you shared - that losing baby girl would be "natural". Did you punch that person? I might have done. You're right in saying that you could say most deaths are "natural", (you could die from touching the wrong leaf in the garden!) but that doesn't make it any better or easier or okay in any way. I wonder how people think saying things like this are okay? ARGH! I agree it goes back to the TTC days when people would say bullshit things like, "it'll happen when it's meant to" or that if you can't get pregnant then maybe you aren't meant to be parents. Yeah, thanks for that, it's exactly what I need!

I think you've got the right idea not buying any of the big ticket items - not because I'm not rooting for baby girl (I really REALLY am!!) but, like you said, if something terrible did happen then you would be haunted by these extra bits and bobs that you don't need. If you've already decided on the models you want of the crib, stroller, bouncers etc., you have plenty of time to get them. Our nursery delivery didn't even show up until I was 34 weeks along! Things can always be bought after, but much less easily returned without the heartbreak that would accompany them. Even I felt a little superstitious when my mum bought us a Snuzpod (a little sidealong crib for Wriggles) when I was 14 weeks pregnant. I just kept thinking - what would happen if we lost the baby? What would we do with all these things? It's so hard to really know, even in straightforward, singleton pregnancies. And even after the baby is born, so many things can happen. I'm not trying to be grim here, jut realistic. Life is so unknown and you can only do so much to prepare so I think to help my anxiety, I've just had to ignore some of the more scary outcomes. Okay, enough negative thoughts - I've got nothing but positivity for Margot!

I love how you have completely embraced your little sweet babies no matter what the outcome. They are no longer big question marks about weather there will ever be a baby, as they are already there and growing. All we can do now is love every little piece of them. I'm so glad that Margot is moving so much and that every day inside of you is another day of development and improving their outcomes. I'm glad you can take as much rest as you need and focus on the most important thing now - your sweet babies.

Not much is happening on this end, I've gotten even more giant (how is that even possible?) although I secretly love it. My braxton-hicks contractions come much more often and I am drinking crazy amounts of water (like 4 liters a day!) which means I get up every 2 hours in the night. I had a midwife's appointment on Friday and everything is fine. Wriggles is still growing (but still measuring one week behind, which is okay), my iron levels are terrific - she even commented that she has very rarely seen such good levels. My secret is spinach smoothies! I make a fruit smoothie with whatever is in my fridge, usually mango, pineapple, raspberries, etc., then add in a few handfulls of spinach and top it up with ice and orange juice. The spinach gives great iron, especially when put with vitamin C. Plus it tastes amazing! High iron = high energy and is probably why I am still able to work. Only one more week left! Nothing else new came out of the appointment, other than Wriggles is head down, on the right and still not engaged. This worried me a bit, as most first time babies are engaged around 36 weeks. I don't mind going over my due date, but I really don't want to have to be induced if I can avoid it. I'm now googling ways to get baby to engage - walking, bouncing on a ball, pelvic tilts, etc. and will be trying some of them. I had a panic that maybe my pelvis is poorly shaped or too small (this happens sometimes), but then I decided that there is no need to worry. I'll take things as they come. I have another appointment in 2 weeks so fingers crossed for then.

I hope you are having a nice relaxing weekend! We had terrific weather all last week and now it's steadily raining. It means I can do some more nesting, and I think I'll start by adding labels to the nursery drawers and reorganizing the linen cupboard... It's funny how I want everything just so before the little one comes as it's one less thing to worry about! Sending good thoughts your way and hope you have a nice week.

[inthemetro]

I'm glad to hear your midwife's appointment went so well. That's awesome about your strong iron levels. How great about the spinach smoothies! I hadn't even thought of it--I plan to shamelessly copy you when I get home from work. That sounds delicious, and incredibly healthy. It's great that Wriggles is growing well, and you're right not to be worried about one week behind--I've learned that there's a actually a lot amount of variance in totally normal babies (my baby boy as of last appointment was measuring over 1.5 weeks ahead, and that's totally normal, too). And it's great Wriggles is head down, that's an important first step. I'm rooting for you that s/he engages, and that you can avoid induction, and that you have good news in two weeks.

And your attitude about taking things as they come makes a lot of sense--it seems like even the worst case isn't so bad (a lot of people get induced and it turns out well). Anyway, I've found NCT class has been great for that, just understanding in a matter of fact way the various contingencies of giving birth. And it's made me feel much better about getting a section. It's too risky to subject growth restricted babies to contractions, so assuming that there's a happy ending for baby girl I'd be an automatic c-section no matter when I deliver. I liked getting to better understand how that would happen, who would be in the room, etc. I like that the NCT classes don't have an overly natural focus, and there's another woman in my class who knows she definitely needs a section--you know my feeling on what's natural (though that comment from a friend I told you about was the absolute worst--I ended up saying very little in response, I think largely because I was so shocked). Anyway, particularly given the direction my pregnancy's headed in, natural is out the window, and that's fine. It's most important that the babies are safe, but still, it's nice to feel calm about that part of it.

Thanks for the thoughts on putting off big ticket item purchases. I'm starting to understand the Jewish superstition about not buying anything before a baby's born. Plus it's only putting off the real "twin" stuff--the double stroller, etc, and I feel like we're already prepared enough by knowing what we want. It's nothing that a few online orders can't fix. And I hope the rain (which we have here too) is giving you some cozy relaxation, even in the craziness of the week--it's always nice to curl up with a book or movie and a cup of something nice and hot. (Speaking of cozy: just the name "Snuzpod" sounds cute and cozy! I bet Wriggles will be very snug in there!)

I'm happy to report my glucose test was totally normal. Phew. For reasons I don't totally understand, diabetes can make placental problems more dangerous and the doctor last visit reminded me twice to get the test quickly, so it's good to know that's not something we have to worry about. (I was also a little worried about having to cut out fresh bread from my diet--I've kept sweets to an absolute minimum, but I would have been sad to have give up my fresh baked bread habit.) Meanwhile my next scan is tomorrow. I also have a midwife's appointment the day after--not ideal timing, but I've found it impossible so far to do what they suggested (not having more than one appointment a week) because I have so many appointments, and I figured since I'm already weeks late to see the midwife I'd just get that done this week too. Anyway, at the scan tomorrow DH and I have everything crossed that we find out at least that baby girl is stable. Stable at this point sounds good. In cases like mine everything's scan to scan in terms of planning for the future, but I'd love to have an appointment where our hearts aren't in our throats the whole time. I'm trying to be cautious (and of course am nervous beyond belief), but I'm also comforted by the fact that they both have been quite active, and my belly's getting progressively larger, and has definitely grown a lot since two weeks ago. I weighed myself at my glucose test and found I've gained a little over 10 kg (!!) since my pre-preg weight. Though I'll definitely keep asking all involved if it'd be helpful to the babies if I gain a little more quickly, so far no one's been concerned on the weight front.

Anyway, I hope your work week isn't too crazy. I'm glad to hear your energy levels are good, and I hope you feel good about the fact that Wriggles could come at any time now and be completely ready. I love how the elephant is nearly at the end of your ticker! I hope you and your DH are getting a little bit more dating and just some quiet nights in while you savor the excitement.

[Little_Bits]

I just wanted you to know I'm thinking about you during this appointment today and sending positive thoughts your way! I'm on the edge of my seat and hoping like you that all of your positive signs (gaining weight, movement, etc) will all lead to a good ultrasound!! Let me know how it went when you get a chance!

[inthemetro]

Thanks so much Little Bits for the check in. We're back from the appointment, and to start with, there's good news: baby girl is still growing. She's grown steadily since last time and even kept her growth curve, and she's clocking it at 1 pound, 6 ounces. The state of her placenta and blood flow haven't gotten worse--also a good thing. As long as she stays like she is, the best place for her (even if we only consider her interest, and not her brother's) is inside me, so our best case scenario is that she holds steady as long as possible. Other good news: while she's small for her age, she continues to look good (no signs of what they call "fetal compromise" or, as is common in cases like hers, chromonosonal or other disabilities--I'm very grateful we had the Maternit21 done). To be fair, after the last appointment, this was probably the best case scenario.

The problem, though, is that her blood flow hasn't gotten any better, and it won't. The doctor said her placenta could fail at any time, and whenever that happens to save her life she'd need to be born right away. His best guess was going off of averages, which would give her about four weeks' time, though it could be either more or less.

Given her weight and gestational age, she's viable right now, so it puts us at a place where we have to make choices. What DH and I need to decide, in consultation with the doctors and as soon as possible, is the point at which we will deliver both babies to save her life. Baby boy is still absolutely healthy and at the top of his growth charts (he's 2 pounds 10 ounces). But being born early puts him at risk of a variety of long-term problems (including cerebral palsy, hemorrhage, etc. etc.). Even if they were to be born right now (which won't happen), chances are overwhelmingly good that he'd survive, but he'd have a significant risk of long term disability associated with prematurity, risks that decrease the longer we wait to deliver. Of course, these choices are harder because we can only know the probabilities--we can't know *for sure* that he would be born without long term disability at *any* gestational age, we only know that the longer we wait to deliver, the better the odds get. It's great baby boy is big, but it seems like the biggest determinant of his long term prospects will be his gestational age (though that said, whatever age he's born at, he's still better off being bigger). We are going to meet with a neonatal pediatrician tomorrow to talk about specific dates and specific percentages.

So this gives us some idea about how the future looks. First we pick a date after which we will deliver to save baby girl's life. If we reach that date and baby girl is still holding up, I'll be admitted to the hospital. They'll monitor me very closely, and as soon as baby girl starts to fail I'll have an immediate c-section. Of course, if she holds out, they'll just keep monitoring me. If I go to the hospital at 28 weeks, there's of course a chance (one we'd all welcome!) that she holds out until 32 weeks, in which case I'd just have a very long hospital stay. A grimmer possibility--and part of the calculus here--is that whatever date we pick, baby girl may not make it to that date, and that's part of what we are facing.

Anyway, we meet with the pediatrician tomorrow and we go back for another ultrasound (which will have the Doppler scan that measured blood flow, same as today) on Friday to see how's she doing, and on Friday we hope to have our date set, so we'll know when (assuming baby girl keeps going) I'd be admitted to the hospital. We're looking at 28 weeks. It's brutal. I want desperately for our baby girl to make it, but I also feel brutal about potentially sacrificing our healthy boy's health (or even, in the worst of cases, his life). Anyway, that's the quick update, and in the meantime we just keep hoping that baby girl keeps being as tough as she's been.

[Little_Bits]

Hey inthemetro,
Thank you so much for taking the time to update me, I was worried all day. First, I am very happy to hear the positive side of this - that baby girl is still growing and that the blood flow hasn't gotten worse. I have to say, I am so impressed with the continued care that you are getting and shudder to think what this might have cost if you were in the US. You've been put in a difficult situation with no clear "right" choice, only the best choices you can make based on the information you have. At least you have a lot of scans and consultations coming up that can help point you in a direction that will be best for you. I really like the idea of you being admitted to hospital and then closely monitored to allow the babies to grow for absolutely as long as possible. I think I'd take a *very long* hospital over the anxiety of being home and wondering if my baby was okay. If you pick 28 weeks to go into hospital, at least thats only 1.5 weeks away, many of those days which are already filled with appointments.

You're in a situation that no parent should be in, having to decide what is the least risk to her children, even though everything seems so risky now. Deliver early to save one baby's life and put the other at risk? But you have to do what you feel is best, and you have great medical care behind you ready to help. I also hope baby girl keeps being tough and growing and showing her fierceness and that there are no big signs of fetal compromise. At least the doctor thinks the average is in 4 weeks (better than nothing!) before anything starts failing, although I understand that is just statistics. I'll just keep hoping and crossing every finger that baby girl hangs on. She already knows she is so loved and I'm sure she is determined to meet you and your DH!

Not much going on here, just a countdown to Mat leave (3 days!) and my parents' arrival (1 week!). I feel alright, rather large but that's normal at this point. Honestly I have nothing to complain about and more than anything I want your babies to be safe and growing inside you. I'm sending more positive vibes your way!

[inthemetro]

Thanks so much for the reply, Little Bits. It's all been a whirlwind. On the one hand, I'm so happy and grateful that she's held out thus far. And I realize to a certain extent having choices is a a very good place to be in, as opposed to where we were only a few weeks ago. And feeling her active is always a wonderful reassurance.

Today we spent 2.5 hours with a neonatal pediatrician, who was wonderful. He talked to us about odds, and basically emphasized that baby boy's odds are quite good, particularly given that he's healthy and not facing any stress or problems, he'd only be dealing with prematurity. Baby boy would be overwhelmingly likely to survive by 28 weeks--probably around 90%, and he'd have an 80% (or so) chance of surviving with no long term damage. Which are both great numbers, and also scary (what if he's in the 20%, or the 10%?). It's hard to read odds, but the consultation made me feel a lot better about the possibility of having them be born at 28 weeks (particularly for the moral quandary about subjecting baby boy to such a premature birth).

Another question we got answered: while if you have two babies of the same gestational age, the bigger one does somewhat better, premies tend to "act their age" a lot. Which is less good than we'd hoped for baby boy (who is super big), but very hopeful for baby girl (who's so small). We also got a tour of the intensive care unit, high dependency nursery, and low dependency nursery, which was both really emotional (it's scary to see babies so tiny in their little incubators, particularly the ones with so many tubes), but also hopeful seeing how many parents were there quietly holding their babies for skin-to-skin. It was also hopeful--everyone's so nice, it's so calm, they are truly places where medical miracles are happening), and they seem like they are open to parents being around all the time (and there are no visiting hours for parents: we could be there 24/7). The hospital here is one of the top ten in England for neonatal care, and one of the nice things is that we got reassurance that we won't have to get split up (the only thing they're not qualified to do here is neonatal cardiac surgery, and given how many scans the babies have had and how many doctors at this point have looked at their hearts, chances are minuscule that either of them has some kind of undiagnosed heart malformation). We also learned that based on averages, if the babies were born at 28 weeks they could expect to be discharged in about 10 weeks (1-2 weeks in intensive care, and then graduating through less and less intensive interventions).

It was also interesting getting the perspective of a neonatal pediatrician. The pediatricians aren't involved really with decisions about when to deliver (that's what the high risk OBs do), but they're just used to intervening with whatever babies arrive. For him, 28 weeks seemed like pretty solid, non-risky territory--he's used to dealing with 25 weekers, which also helped put what we're facing in perspective.

Anyway, the big decision is 28 weeks vs sooner for me to get admitted to the hospital. I think something will hinge on Friday's scan--if baby girl is failing then, could we let her go? I doubt it. But maybe I should just be admitted then? It's hard to know--particularly how awful it would be to lose her at 27 weeks, 6 days. I definitely hear you about how it will be easier to be in the hospital, be monitored constantly, and have it be out of my hands. I won't have to worry constantly if she's failing. It's funny that DH is much more worried than I am about a long hospital stay--for me, I'd be fine just hanging out, doing tons of reading, and given that there's internet and I'll have my computer I could even finish writing my article and have DH fetch library books for me.

And on you: the countdown to Mat leave continues. So so close! I hope you have something to celebrate your last day (bittersweet, of course, but mostly happy). And that's wonderful your parents are coming so soon. And I'm glad you're feeling good--I hear you on large (I feel large and I'm not even far along!). Are you guys feeling more ready? Do you have a midwife's appointment coming up?

Anyway, sorry for the long and disjointed post. I feel strangely hopeful about baby girl holding out longer than 28 weeks, too, particularly as she's kicking pretty strongly as I write this, though as always, there's a knock on wood element about it. And the "right" choice is tough--it's really so hard to know. I'll definitely let you know how Friday goes, and I'm just hoping this part of the pregnancy goes fast: the grey zone before I get admitted to the hospital, and I can start feeling confident that baby girl is going to make it.

[Little_Bits]

Another busy work week is passing in a blur, but I wanted you to know that I'm thinking of you again today! I'll keep checking back in just in case you get the chance to update me on today's appointment, I hope all goes well and I'm glad the visit to the neonatal intensive care unit went well!

I'm off to teach my last day of class for a year - yay! No more wake ups (until the baby arrives, of course!)

[inthemetro]

Thanks, Little Bits. My news: baby girl is holding steady, which was a huge relief. She's still growing, and no deterioration whatsoever in her blood flow. DH and I decided to wait until a week from today (when I'll be precisely 28 weeks) to be admitted. The doctor, while acknowledging the possibility that she could fail before then, thinks she's quite likely to make the week. And given how many things are in play, delivering until 28 weeks would be heartbreaking. But losing her would be incredibly heartbreaking. It's hard to know what to do, but the doctors think our choice is the reasonable one given the circumstances. DH and I had a long night going back and forth, and it's a choice that's very hard to feel good about either way. In any case, I think both of us have a lot of hope and faith that baby girl's a real fighter.

It's going to be a looong week. But for you: I'm so glad you made it to the end of your work year! Congratulations! And I wanted to say how I talked about you to a new friend from my NCT class who's a primary school teacher. She was planning on working until 38 weeks, but it's exhausting her so much she is starting her leave at 36. So I'm not the only one who's impressed! Do you have anything on the docket to celebrate? And I can't believe that very soon I'll get Wriggles baby spam and birth story news!