The weekend in Boston with my sister (Jenny) and Mom for Jenny's bachelorette party and bridal shower was really fun but definitely exhausting for a pregnant girl :) On Saturday, we went to lunch, then hung out in the afternoon, then went to a late dinner. After dinner, the other girls took Jenny out for some dancing and drinking while I went back to the hotel room to sleep. I made it until 10:00, which I thought was pretty good :)
Unfortunately, during the day my Mom found out that her Dad was in the ICU, so she ended up having to leave a day early in order to go home and then go to Ohio on Sunday to see him. He ended up passing away on Sunday before she was able to see him, but thankfully she had seen him just a few weeks before that and had spoken with him on Saturday, so she felt like she had been able to say goodbye. But it was still hard for her. Despite going through that, she remained strong and took care of all the stuff that needed to be taken care of to get ready for his funeral and start figuring out what to do with his house.
My Mom is such a strong woman and I like to think that she has passed that strength on to me. In difficult times, she will take the time to break down and get upset, but when needed, she is able to push that aside and take care of things. I really admire that and I hope that I'm able to do that for my children when they go through hard times, and I hope that I am doing that well for Brady now, because he needs optimism and love even in the womb, so I don't want to focus on too much negativity or sadness.
So, on Monday, I came home from Boston and worked Monday afternoon and Tuesday. On Wednesday morning, we went to our next OB appointment. Before the appointment, we met with Lisa (the social worker who is working with us on scheduling appointments and just basically figuring out how to get through all this) to take a tour of UNC Woman's Hospital. It was super nice. We got to see one of the delivery rooms, which was so nice. The rooms are really large and completely private, with a private bathroom. They have a couch to sleep on, tv, music, and what looks like a fairly comfortable bed. There is even a little area for the baby to sleep with a warmer over it, so that Brady can be in the room with me, unless he has to go to the NICU.
When we were in the room, we discussed how we want delivery to go, and Lisa said that we could make decisions such as whether we want the blinds up or down, what music we want on, if we want Brady to be cleaned up before given to us or if we want him put directly in my arms after he's delivered. So many things to think about! I had no idea! But I'm so thankful that I have Lisa to bring those things up and help us make those decisions. We then went to see where we would prep for a c-section, if that becomes needed.
After the tour, we met with our OB. I had my blood pressure taken, and it was still a little high (134/84), but still much lower than it had been at the beginning of my pregnancy, and it hasn't increased since the last appointment. They now want me to take my blood pressure once a week to make sure it doesn't increase drastically in between OB appointments, since I'm a little more at risk for preeclampsia because of Brady's single umbilical artery in the placenta. They also weighed me and I was 148 lbs, so I only gained 3 lbs since my last visit 4 weeks ago. Hopefully that just means that Brady is growing but I'm not ;)
We then spoke with the doctor about our plan for delivering Brady. We had decided that we wanted a scheduled c-section to reduce the strain on Brady during delivery, so that he would have the best chance possible of survival and minimal trauma to his spinal sac (from the spina bifida). We were told that in a typical pregnancy, if the baby is in distress and it is determined that he will do better outside of the womb, they will induce labor or do a c-section before full term in order to get the baby out of that situation. However, with a T-13 baby, they would not recommend that because the baby has a much lower chance of survival.
Paul and I hadn't really discussed if we would want to get him out early if he was in distress yet, so we talked about a c-section and the doctor said that having a c-section before full term would be risky because the uterus isn't wide enough to do a horizontal incision, so they would have to do the old school vertical incision. With the current horizontal incision, there is approximately a 1 in 200 or 1 in 400 chance of rupture in a future pregnancy, which is pretty low. With the vertical incision, there is a 10% chance of rupture, so my doctor said that she would not do one for me. Paul and I agreed that it would be too risky, so we decided against do a pre-full term c-section.
We then discussed the possibility of a scheduled c-section for full-term delivery. The doctor asked the reason we wanted to do that, and we said we wanted to give Brady the best chance of survival and minimize additional injury. She said that the research on spina bifida requiring c-section to reduce injury is inconclusive because the test case groups have been very small and they haven't really been followed up on, which seemed to agree with what I have seen so far on that topic on the web. She said that the doctors at UNC had just reviewed that research that week in order to update their policies on spina bifida babies in general and they had decided to do vaginal births instead of c-sections because the research is inconclusive. So for our situation, she recommends the same course of action, but that we would monitor Brady closely and if he goes into distress, we will do a c-section.
Paul and I feel comfortable with that plan, so we are happy we were able to discuss it with the doctor. Many T-13 babies have gone through a vaginal birth just fine, so we feel that it makes sense to see if Brady will be able to handle it, and if not, we can then do a c-section on the spot. We feel comfortable that the doctors and nurses are good enough that they will take care of Brady if he isn't doing well at any point (there is a central station where they can monitor me and the baby even when they aren't in the delivery room).
After the appointment was over, we made follow-up appointments for August 30th to get another ultrasound, a fetal echo, and meet with the neonatologist. The fetal echo is a type of ultrasound that is able to target the heart and get a more accurate picture of the structure of it. After the echo, we will meet with the cardiologist to ask him questions about what he sees. The neonatologist is a doctor who focuses on the care of infants, especially ones that are ill or premature. I think they run the NICU and manage the neonatal nurses. He will be able to answer questions about the care that Brady will receive after he is born and the possibility of various surgeries (for the heart and spina bifida) after Brady is born. So August 30th will be a very long day, but we figured we would just get everything over with at the same time.
After the appointment, we got on a plane to Ohio for my Grandpa's funeral. The viewing was Wednesday night, and that went fine. The funeral was Thursday morning, and that was a little difficult for me because it made me think about the bad possibility of Brady not making it, so I was really glad that Paul was with me to support me through that. We got home super late Thursday night, so Friday was a little rough. The weekend was also tiring because we had a lot of errands to run and chores around the house, but I got to go to a concert with some friends on Sunday night, and that was really nice because it got me out of the house and having fun and not focusing on this situation. Brady seemed to like the music :)
I have really begun to wear a lot of maternity clothes now because of my growing belly, so that's a little weird to transition to. Brady is sitting really low, so it's just not comfortable trying to fit into regular shorts anymore, even with the belly bands or rubber bands.
I continue to use the fetal heart monitor every day and it continues to give me peace. I'm still unsure about the "movements" I am feeling, but I gotta think they are Brady since I never felt these kinds of movements before I was pregnant and they are so random that they don't seem to correlate with anything else (like gas :)). According to one of my books, Brady is supposed to double his weight in the next 4 weeks, so I'm really hoping that means I will start to feel more substantial movements by then. I'm really interested to see how big he has gotten at my next ultrasound. I really hope he has started to catch up and isn't further behind, but we'll see.
I still have my moments of breaking down, but they pass pretty quickly thankfully. They usually occur when I am stressed about something else or just plain tired, so that is pretty normal. Otherwise, I just try to focus on enjoying each day and connecting with Brady. Paul is continuing to read to him every day, which is really nice, and he talks to him and kisses him. It's really nice that he's connecting with Brady too.
Thank you all for your continued support through all this. We really appreciate it and are so grateful we have such wonderful family and friends. This situation would be much harder without you.