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small for gestational age

BABY ON BOARD Pregnancy updates

36 Weeks

36-weeks-lifebylotte

Officially over 11 stone now. You’d never guess right?!

Oh god, there is SO much to say at 36 weeks. Apologies in advance, I think this might be a long one so do bear with me (or don’t, feel free to bugger off and spend your time doing something more productive…).

In my head, this week somehow seemed to be the week everything was leading up to – the week of my final scan, the week by the end of which I would be officially ‘full term’, and also the week where I got to see a midwife for my check up, rather than my GP.

So first off, we had the scan yesterday. We saw a different sonographer AGAIN (meaning I think I’ve seen seven in total!) but she was perfectly chirpy and nice, and spent a good five minutes looking through all my paperwork. ‘Goodness me, you do have a lot of blue forms!’ (they give you a print out of your scans on blue paper after each one). So she didn’t really waste any time with preambles and got straight to it.

The upshot of the scan was that Chip is still head down (‘very low’) and still small (no surprises there), but growing on the exact same percentile as before, which is all good. She apparently now weighs 5lb 8oz, which sounds perfectly respectable to me. Although I did read somewhere online that estimated fetal weights are about as accurate as trying to guess the weight of a naked man sitting in a bath in the next room. So, yeah. But still, looking at it positively, she’s put on a fair bit of weight since my last scan at 34 weeks.

All was good with the blood flow and dopplers and amniotic fluid, and the sonographer got quite excited at one point when she was measuring Chip’s tummy.

‘Look at that! Can you see how it’s moving up and down?! That’s her diaphragm practising breathing, and it’s a really good sign. It means her brain is getting so much blood and oxygen that she even has energy in reserves to practise developing those muscles too.’

All this was very reassuring, and cheered me up. The only rubbish bit was that the sonographer was clearly keen to get me done and dusted and outta there, so I didn’t get to see Chip’s face which I was kind of hoping for one last look in utero at (mind you, the head was squashed right down between my legs so maybe a good thing). Scans at 36 weeks are really crap actually, because the baby is so big you can’t see it all in one go, and the bits you can see don’t really look like much.

Anyway, the sonographer seemed all pleased but then she – rather worryingly – popped off her chair and said ‘I’m just going to have a word with the doctor, wait here’ and disappeared for about ten minutes. Of course, we spent those ten minutes comparing notes on what we’d seen on the screen and fearing the worst (Oli and I now both think we’re experts at interpreting the results of all the measurements when, let’s be honest, we have literally no clue what they mean).

But then she came back and said that she just wanted to check with him that they didn’t want to see me for yet another scan, and he’d agreed that THERE WAS NO NEED! HURRAH!

So, I’m all scanned out! The next time I see my baby (fingers crossed) will be when she’s on the other side!

Here are her vital stats at 36 weeks for anyone wanting to compare and contrast…

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You can see here my ‘off the chart’ result for the left uterine artery…

36-weeks-scan-lifebylotte

And here you can see where her AC (abdomen) and FL (leg) measurements dropped down to the lower percentiles halfway through developing…

The sonographer then took me along to book me in for my induction. Because of the issue with the artery gubbins, I am not allowed to go longer than 41 weeks – I think with normal pregnancies they don’t talk about inducing you until after 42 weeks.

My induction date is officially 3 September. I am hoping and praying that Chip puts in an appearance before then, not least because the description of the induction is pretty depressing. Apparently they put a pessary up your wotsit, which ‘ripens’ (YUCK YUCK YUCK) your cervix, and once it’s ripe (YUCK KILL ME NOW) then they break your waters for you, and then they give you shitloads of synthetic oxytocin to start labour off. But the pessary has to stay in for twelve hours, and often doesn’t even work the first time, which means they put another one in, and wait another twelve hours.

Basically the whole thing can take days. She said it can be up to as much as 56 hours before you’re even in labour. And you have to stay in hospital the whole time. And you can’t have a water birth or be in the nice lovely birthing centre. So it sounds like a bloody nightmare, quite frankly.

I did work out that if the worst came to the worst, there’s a chance that Chip could be born on 6 September – which would be exactly seven years to the day since I met Oli. I quite like that idea, even though 6 September seems like an unbearably long time away. We’ve put bets on when we think she’ll be born, and Oli’s gone with 24 August, and I’m sticking to 6 September because somehow weird coincidences like that seem to happen a lot in my life. Time will tell…

Today I had my midwife check up, and was desperate for her to say that Chip’s head was engaged and that she thought she’d be born in the next week or so, as seems to have happened to so many of my friends who had their babies the day before they were meant to go on maternity leave etc. But alas, her head is still ‘free’, which means she’s not in any way ready to be born yet. Boo.

The midwife was super reassuring though, and said my GP was crap to have ‘panicked me’ before. She measured my bump at 34cm, which is completely fine for 36 weeks. She said the heartbeat sounded great, my blood pressure was super low, my urine was fine (HA! this time I had my sample ready – *smug face*). I got some blood test results I’d completely forgotten about and apparently they were perfect, especially my iron levels. She did look a bit sorry for me when I showed her my swollen feet though. I knew I wasn’t being melodramatic about them… *cue violins*.

I told her my boobs were already leaking a bit (sorry TMI) and she almost applauded me and said how great that was, which was nice too. She also said about four times ‘There is nothing wrong with your lovely compact baby!’ which was SO what I wanted to hear. She even taught me how to tell which bits of the baby you are feeling with your hands, which was really interesting. She said the head will always feel rock hard, the back is a long solid curve, and the bottom is, well, bottom-like. She was awesome actually, and I hope she’s on duty when I give birth – she really seemed to be interested in me and the baby. It’s just a shame you don’t see midwives for every appointment, but anyway…

Phew! This is indeed a long one. Luckily, I don’t have many other boring symptoms to share with you this week. Apart from that every night for the past week, I’ve had a different dream about being in labour (guess this is standard for this far along!?). And that I’ve been trying to listen to my hypnobirthing playlist once a day but I keep falling asleep. But if it works like that in labour then I guess it’s no bad thing?!

BABY ON BOARD

The Fetal Medicine Centre – Wellbeing Scan

harley-street-door

This is a picture of a door on Harley Street that caught my eye on the way to the scan. It is *not* the door of the scanning centre and has no real relevance to my post, but y’know, you need a pic when you do a blog post, right?

I just wanted to do a quick update, for all the lovely people who’ve showed an interest in my midget bump’s story. Thank you so much for all your support and good wishes, I’ve been quite touched.

So, we went for our private scan at The Fetal Medicine Centre last night, just really to get some more answers. The sonographers at St George’s are wonderful, but you’re always hyper aware of all the other ladies waiting to see them and don’t want to take up too much of their time. So for me, really, the point of the private scan was more to be able to talk to someone at length about exactly what was going on, rather than just finding out another bunch of figures about Chip’s size.

After a bit of a wait (they were having issues with their systems), we were seen. I explained to the sonographer what we’d been told before and he spent a good half an hour thoroughly measuring Chip, as well as the various different blood flows to her and my uterus. The first bit of good news was that she had moved and her head was firmly down! I couldn’t believe it – after all these weeks!

Anyway, the upshot of the scan was that overall she’s still tiny – the 7th percentile – and still ‘small for gestational age’. However he was able to measure her head better this time than at my last scan, because of its position, and it’s measuring much more normally, around the 40th percentile. Only her tiny tummy, legs and weight are holding her back. So she’s got a big head, a titchy abdomen and no fat on her, basically.

He said she is a very small baby, but he could see no reason for it really. The blood flow from the umbilical cord was fine, as was the amount of amniotic fluid. She was wriggling about on the scan (she was rubbing her little fists into her eyes, which was very cute, but meant we couldn’t get a good picture of her face – sniff) which is also a good sign.

He said she looks perfectly healthy, just small. There was a moment of absurdity when he said ‘She might just be small because you are…’ and then looked at me (5ft 7) and Oli (6ft 3) and shrugged.

Interestingly, he also said that scans should never be done less than two weeks apart, because the margin for error on the machines is so great that measurements that close together can be unreliable. BUT – she had grown since last week’s scan, not by much, but by the same amount as before, meaning she was following the same growth pattern, which is good. It means her growth hasn’t slowed any further, by the looks of it at least. He said next week’s scan at the hospital will give us a better idea as we’ll be able to compare it to the one a fortnight before.

I asked him about the possibility of an early delivery and he said at the moment there’s no reason to think that would be necessary, and that they would only do that if her growth started to tail off on the chart, which would show she was deteriorating. So for now, I feel reassured.

It’s still upsetting to think she’s going to be tiny and vulnerable when she’s born, and part of me is still terrified there’s something chromosomal going on (he said this was unlikely as we’d had a very low risk result on this from our testing at week 12, but nothing is failsafe). Most likely, for some reason or another, my placenta isn’t working as well as it should be, but so long as they keep a close eye on it, they’ll be able to intervene if it starts to pack up completely.

Last night I actually slept properly for the first time in over a week – it was such a relief. I’m still nervous about everything and what the future holds, but I’m also feeling more positive, and I’m so pleased her head is the right size for her age. Hopefully the rest of her can catch up after she’s born. (Tiny) fingers and toes crossed!

(here’s her notes for anyone who’s interested in the technical stuff…)

chip-notes-lifebylotte

BABY ON BOARD Pregnancy updates

33 Weeks

Yes I am as tired as I look

Well, I’m not going to lie. I’m 33 weeks pregnant and this week has been an absolute shocker. I think my personal low point came at around 1am one night when I lay in bed whimpering to Oli: ‘I thought I was a strong person. I want to be a strong person! Why am I not feeling strong?!’

All had been going quite well really, as my chirpy 32 week update will attest, but then I had my 32 week check up with my GP. My urine was fine, the heartbeat was fine, my blood pressure was up slightly but not terribly, but then the doctor measured my bump. It measured 27cm – the same as it did four weeks ago. Now, I know that fundal heights are pretty unreliable, and that anything within a 2cm range is OK, but measuring 27cm meant not only that my bump was 5cm too small for my dates (bump size should measure the same in cm as you are number of weeks pregnant) but more importantly, that it hadn’t grown at all for a month. This is referred to as ‘static growth’. An oxymoron, but whatever.

The GP told me that I had to go and have another growth scan first thing the next day (unfortunately my appointment with her was last thing, and the scanning unit was shut). Cue a rather sleepless night, then we rocked up the next day to a full waiting room of nervous pregnant ladies. I gave the receptionist the letter from my GP referring us, then we took a seat, expecting to be there for hours. But within about three minutes my name was called – never a good sign!

We went off to be scanned, mostly hoping to be told everything was fine to be honest – and that my bump was small because of my long body, as it had been last time. But unfortunately Chip’s growth has slowed right down. She had been measuring on the 50th percentile for growth, but now she was only measuring on the 5-10th. An official verdict was announced – Chip is ‘small for gestational age’, with all the complications this involves. She’s also very firmly in a transverse breech position…

33-weeks-transverse-lie

Yes, that is my baby’s head very firmly sticking up on one side of my stomach. Apols to squeamish folk

The sonographer tried not to worry us but did impress on me the importance of keeping an eye on her movements, and if they seem to lessen at any time, to come straight to the hospital. I’ve been a nervous wreck ever since. I also have a placenta at the front, which means I never see her kick really, I just feel rolls and thuds inside my tummy. My days now consist of large portions of time spent lying on my side and playing her music, just to make sure I feel ten movements within an hour. It’s stressful.

I’ve cried a LOT – late at night, in the M&S sweets aisle, while watching TV… poor Oli. My other method for dealing with this situation is to try to get as much organised as possible – hence we’ve picked up the buggy, cot and car seat, and I’ve washed all her clothes and packed my hospital bag, just in case I have to go in early. That has given me something nice to focus on, and has made me feel more and more excited to meet her. Here was the car after our trip to the A3 Baby Barn

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Not only do we need a bigger flat, we need a bigger car!

We have another scan at St George’s next Thursday, but in the meantime I also booked a private scan for tomorrow at the Fetal Medicine Centre. There’s so much I want to ask and I just wasn’t really in the right state of mind last week. I am aware that if the issue with my placenta means that she’s not getting enough nutrients etc, the best thing is probably to have her early but the sonographer wouldn’t suggest that until she’s compared her growth over two weeks. But I am also terrifyingly aware that I’m now at a much higher risk of stillbirth – hence my 1am whimpers.

If it was up to me, quite frankly, I’d whip her out right now. I really want her to just be here and safe, and I’m so afraid of my body letting her down. It’s been very difficult to hold it together in general really – it’s a kind of low-level anxiety that’s ALWAYS there at the moment – is she moving enough? is she OK? what is going ON inside me?

The only nice bit about last week’s scan actually was seeing that she has a full head of hair! That did make me sniffle a bit. (and also, the perverse side of me couldn’t help thinking, why is she growing completely unnecessary hair when she needs to put on weight and grow her head and tummy instead!?)

What’s interesting too is that I actually am really lucky. If my hospital didn’t do doppler scans as standard (many hospitals don’t) I would never have found out about the issue with my uterine artery resistance. In my many google sessions this week, I came across this Panorama documentary from the BBC about this very issue, and about how many stillbirths could be prevented. It’s worth a watch, if you’re pregnant or concerned about your baby’s movements. Really, the thing I’ve learnt from this experience is that keeping an eye on how much your baby moves is absolutely bloody critical.

Anyway, I’ll probably do another update after my scan tomorrow. I’m praying for good news. I’m eating like an absolute pig and I’ve put on 2 lbs in six days, which I’m hoping is a good sign. My bump feels bigger to me, so I’m keeping everything crossed for a growth spurt. Come on Chip, you can do it!