I keep getting pitches for various pregnancy-related blog promotions (oh, sure, random stranger! I'd love to link to your sketchy-looking site about prenatal vitamins on my practically-defunct, ad-free blog!) and it was confusing me until I came to my own page and realized that, hey, I mainly blog about pregnancy lately. Who knew?
I'm writing less often at Faith & Family since my activity's been restricted, but if you want to read about the kids, I often talk about them over there.
In the meantime, who wants to hear more about my pregnancy?
In nice little bullet points, even! Handy for skipping ahead!
(And at the end I have put a belly shot!)
- Medical care: was dreading it; am surprisingly happy. Obviously the jury will remain partly out on this one until after the birth, but I am feeling pretty confident about that, too.
I had an awful experience with my first OB, who spent my whole pregnancy obsessing about what he clearly did not believe was white-coat hypertension, while also occasionally belittling my desire to give birth without pain meds. ("SOME women can do it without the epidural," he told me, his raised eyebrow indicating he doubted I was one of them.)
The second time, my midwives were wonderful, and believed me when I told them that my blood pressure was normal on my home monitor (WHY would I lie? Why, First Doctor?) and the care was patient-focused and excellent and the birth went beautifully and I was so excited to do any future births with these same women.
And then I got pregnant with twins. I couldn't go to the midwives, and when a friend of mine turned out to be friends with one of the high-risk OBs whose practice is four minutes from our house, and when that particular doctor told her that I would have a good chance of getting to do a vaginal delivery with these doctors, I decided to go with them.
But at the beginning of the care, I had strong reservations. I didn't know how I'd feel about the level of monitoring they were suggesting for monochorionic twins. I wasn't sure I'd like the doctors themselves, since my previous OB experience had been so bad. It was... an adjustment.
Fast forward four months, and I have realized that there are unanticipated advantages to this intensive level of care.
Everyone at the office knows me. Three doctors, four ultrasound techs, four nurses, three receptionists: every single one can identify me by name. They smile and wave when I walk into the waiting room. They're friendly and kind and - just like with the midwives last time - I'm comfortable enough in their office that my white-coat hypertension has disappeared.
I've never gotten medical care this personalized before. It is kind of awesome.
Also, in a way that's difficult to describe, while the babies are getting a LOT of monitoring (TWELVE ultrasounds so far, and I'm only 30 weeks), my pregnancy itself is still being treated as normal. Probably because it is. I've been fortunate to be healthy as anything: low blood pressure, no swelling, no gestational diabetes, on-track weight gain. Except for the excessive contractions, which we all agree are probably just irritable uterus, this is a low-risk pregnancy and the doctors are acting like it's a normal process. Which it is, of course.
Don't get me wrong. With possible future pregnancies, I will be thrilled to return to midwife care. I still think it's by far the best fit for me personally under normal circumstances. But a monochorionic twin pregnancy is not "normal" circumstances, and for what we have to work with, I'm happy. Really, really happy.
Birth: it's going to happen. Some people think that c-sections are the way to go with multiples pregnancies, but I disagree for a number of reasons, not least of which that I have a reasonable expectation of having more children, and I don't want to get on the c-section train. One caesarean is not such a big deal, but four or six would be. I know that VBACs are possible and I'd be a good candidate in the future, but I'd rather just avoid the whole thing if possible.
But at the same time, I'm aware that my chances of needing a c-section for real medical reasons are much higher this time. So I've been praying that, if I'm going to end up giving birth surgically anyway, the babies would just be breech or transverse and we could schedule it knowing it was necessary and I'd never have to wonder.
At 30 weeks, Baby A is head-down. Unless he flips, which becomes less and less likely the more crowded it gets in there, we'll go for the vaginal delivery whenever I go into labor. (Actually, they would probably pressure me to induce at around 38 weeks, but considering my history - Camilla was born at 38w4d and Blaise was born at what I'm pretty sure was 37 weeks - and my current contractions, no one seems to think I'll make it that long. I'm not worried about induction.)
Baby B has his own ideas about proper positioning. He's been mostly breech, but this week was lying transverse across the top of the womb, I'm assuming because he wants my lung capacity to be as limited as possible. But I'm surprised he puts up with his brother kicking him in the stomach!
We've talked birth specifics with two of the three docs now, and this week the second one confirmed what the first told me months ago: they prefer Baby B to be breech, because it gives them a chance to speed up the birth process. "We just reach in and grab his feet," she told me blithely.
(This doctor, who's the friend of my friend and the reason I came to the practice, is the only one I hadn't met yet. I think she might turn out to be my favorite. I'll call her Dr. Cheerful Calm because that's what she is: more personable than Dr. Friendly Nerdy, less frenzied than Dr. Happy Chatty. But I really like them all!)
Dr. Cheerful Calm ended up telling us - as if she were discussing a day on the golf course - a story about this time when a breech baby B had one of his legs up in the right corner of the uterus, and Dr. H.C. couldn't reach it because she's left-handed, so Dr. C.C. elbowed her out of the way and managed to reach the other leg with her right hand. "We got that baby out!" she said, with the same sunny triumph you might use to describe a hole-in-one.
I wasn't sure how I'd like having specialists for my primary care, but I think I've mentioned before how reassuring it is to be their easy, healthy patient. And another thing I am loving is how relaxed the doctors are about multiples birth. It could go the other way - and I've heard that the other MFM practice in town is very c-section-happy - but these docs seem very comfortable with twins and vaginal delivery. I'm happy that I'll have someone with experience at the helm when I'm doing something so unfamiliar to me.
In a strange and surprising (to me) twist, I have decided that I'm going to get an epidural this time. I'm a big fan of low-intervention birth, but there are certain interventions - like uninterrupted monitoring - that are just a good idea with a twin pregnancy, so this will not be the mostly-natural experience that Blaise's birth was anyway. After talking with the doctors about the risks of real emergency c-section, and having to get knocked out for it if I'm not already on anesthesia, I've decided I'd prefer the smallish risk of complications associated with the epidural than with the smallish risk of being unconscious when one or both of my babies is born
(Also, as Dr. Cheerful Calm pointed out when we were chatting about it, if Baby B is breech and they do have to reach up there and get him: yikes! That'd be seriously uncomfortable without anesthesia.)
I am feeling fine about getting the epidural. There's nothing about it that particularly scares me, I've just avoided it in the past because I like birth to be as non-medical a process as possible, and because I want to keep my risk of unnecessary c-section as low as possible. The one thing that concerns me is the timing - if I wait until the pain is overwhelming before I ask for an epidural, there's a real chance I won't have time to get one. I reached that point at about 8 centimeters in both previous births. My idea is to get the epidural at 6 or 7 centimeters this time, so I guess I'll have to have them check my progress so we can keep track of when I get to that point.
(I will freely admit: I like the idea of going through transition without being able to feel it. The rest of it I can handle, but I abhor transition.)
Here's a blurry Photobooth pic of me yesterday. At 30 weeks, 2 days:
We're moving along!