Wednesday, August 21, 2013

When my awesome pregnancy takes a tricky turn

I didn't really get around to writing about the start of this pregnancy. I was too busy globe trotting, visiting family and friends in Hong Kong and England to keep up with it. It is probably worth mentioning that as with nearly all of our pregnancies, I had a scary bleed around week 7. I was in Hong Kong and beside myself when I saw the bleed. I thought it was the beginning of end and despite following up with health providers in Hong Kong who said the baby was still viable I was very surprised to make it back home and do a scan around week 9 that confirmed the pregnancy was progressing well. I still took my time to announce the pregnancy - waiting until week 17 when this little fella seemed well and truly settled in.

This weekend we ticked over into 30-weeks pregnant and dutifully attended our first full day of antenatal classes at the hospital. I've been excited about the classes - it is another marker in the progress in our miracle pregnancy. Hubby thinks 6 hours of sitting at antenatal classes on our Saturday is a drag, but a necessary and useful one.

Day 1 of antenatal classes is a little about familiarising ourselves with warning signs in this later stages of the pregnancy but mostly about understanding the process of labour, how long each stage takes and what is happening at each stage. As demonstrated using a small doll and female pelvis, it is clearly hard work to squeeze a small person out through the female pelvis. Yay!

We did a tour of the birth suites, so we could see where we most likely be bringing our baby into the world. We were shown the parking for dad's bringing in their partners and the pregnancy observation unit, where we will most likely go first up when arriving in labour.

The day was undeniably informative, even it it was a little slow moving and I had to sit in the most uncomfortable chair. I was pretty uncomfortable on the day. I just couldn't settle into my seat. My back and hips were sore. All the other pregnant ladies looked alright, but I kept shifting in my seat.

Pleased with an early mark we headed off to do a little appliance shopping - as I've now decided given it is only 10-weeks to mini matty's arrival that I really should get the damn kitchen renovated. I'm mad! So after some time standing around looking at kitchen appliances, we are pretty happy we have decided on the items we will need to finalise our cabinetry and head home.

I'm tired and sore so I head for a lie down. We have another day of classes tomorrow and I don't want to be a wreck for it. The second day's class is all about caring for our new little chap when he finally arrives.

An hour and a half later I wake up and feel a lot better, I wander out to the lounge room to chat with hubby and suddenly find myself feeling wet. It was weird - I say maybe I've weed myself, but I don't know. Matt is laughing at me as I whisk myself off to the toilet. I do a wee and look at my pants, where I clearly seem to have wet myself. Confused I pat some toilet paper on the wet spots to find the fluid is pink, not wee coloured. When I wipe myself it is clear that blood it definitely a part of the mix and the other fluid could be wee, or given I've just been at antenatal classes I begin to wonder if possibly my waters have broken.

I call Matt in and he isn't giggling about it anymore. He gets changed back into leaving the house clothes and rings the hospital as I try to find something else to wear and a mega pad to catch what ever is going on down there for the nurses and doctors to consider. The pregnancy observation unit want us to come straight in. First win from the antenatal classes - we know where to go and where to park! Oh, and of course we know that bleeding at 30-weeks is a bad sign - but I think we would have been on to that.

It doesn't take us long to get to the hospital and into the pregnancy observation unit. They immediately want to look at the mega pad, so I'm given a fresh one to swap to. The midwife gets me into the bed. She has called my obstetrician, he will be there in about half an hour, meanwhile they want to run a trace on baby to see how he is going. Two different monitor things are connected to me with big elastic straps. One listens to baby's heartbeat, the other monitors what my uterus is doing and the baby's movement. I'm also given a button to push every time I feel baby moving. Despite being pretty busy during the day, I'm not really feeling him much now, so I'm given some water and ice to crunch to try to get him going.

Soon enough our obstetrician arrives. I bumped into him in the morning during the antenatal classes, so he makes a joke about not expecting to see us back so soon. He pushes my tummy a bit to see what my uterus is doing. He tells me it is soft, which is good. He asks about how I've felt, have I had pain, have I had any tightening or contractions? I tell him the whole thing has been painless, just a shock. He wants to do a speculum examination to see what's happening near my cervix. Here things aren't so good. He can see a fair bit of blood and clots. He takes some swabs to be tested for infection.

Now for the verdict. The obstetrician explains he thinks I've had an edge bleed from the placenta, known as an antepartum haemorrhage (APH). He explains that the amount of blood loss I've had and how the cervix looked suggests it was more than just the cervix bleeding. He explains an edge bleed can be a one off and if it settles down with no fresh bleeds over the next 7-days that is considered pretty stable - this is good! However a few not so great things can happen and the window for this to occur is the 48-72 hours following the initial bleed. Firstly - the bleed I've had can cause irritation and trigger contractions and labour - this is bad. Secondly more edge bleeding can occur, leading to irritation of the uterus, contractions and labour - this is bad. Thirdly a complete placenta abruption can occur, leading to contractions and labour - this is bad.

So I have one chance of good, three chances of bad. Hmmmm. The conversation from this point gets a little harder. My ob is going to admit me to hospital for now and with three chances of bad happening the obstetrician wants to start me on a course of steroid injections just in case mini matty is rushed into the world. The steroids will help mature his lungs and give him the best chance if he does arrive early.

At this point my mind starts to catch up we are now seriously preparing for a worst case scenario early delivery. I tell my ob that I'm starting to get a little stressed out and don't mind if I have a little cry. He remains calm and says he'll just continue on. He explains the benefits of the steroids and if it were his baby he'd definitely be taking them. Also even though mini matty is 30+ weeks there would be a benefit in me taking magnesium if I do go into labour. Magnesium is commonly used in pre-term delivery under 30-weeks and has something to do with brain development of the baby. He explains research is currently being undertaken into the benefit of magnesium in delivery of 30-34 week babies, and it seems there is a decreasing benefit, but given I'm so close to 30-weeks there is probably a real benefit in our circumstances.

So he wants me to stay in, do the steroid injections and have twice daily traces run on baby to make sure everything is going okay for him. As if I'm going to say no thanks, I'll go home and take my chances.

My ob leaves and says he'll be back in to see me in the morning. The midwife - who happens to also be 30-weeks pregnant - comes in with the steroid injection and jabs me in the leg. She tells me they are just preparing a room for me upstairs and kindly gets us some shabby hospital sandwiches to chow down, given we've missed dinner and are now staying overnight at least.

Soon enough we are transferred to the antenatal ward and I get settled into my room. The midwives here are very busy and we have a decent wait before I get greeted and checked in properly. We have arrived at hospital with nothing - so I have no pjs, no toiletries, no snacks. Just Matt and I in the room in a kind of shock, both of us willing this to be the one off scenario not any of the other three options.

Once the midwife comes in she tells me about the room. She is very specific about my call button and tells me if I have a problem hit it once, if I have a big problem, ie a big bleed, hit the button three times and they will be there ASAP. This is the first time I've been told about this type of button function and reiterates in my mind they are genuinely concerned about this bleed progressing into something more serious.

We decide Matt should go home and try to get a good night's sleep. I can always call him if anything happens, and he can be back in 15-20 minutes. I've prepared a list of things for him to pack and bring in for me in the morning.

I slip into a hospital issue gown and settle in for the night.

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