Musings of a Marfan Mom

37 Week Update Part 1

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Where to start, where to start?

I hit the 37 week mark at the end of last week. My doctors and I weren’t sure that was going to happen, so Mark and I are very grateful. We’re prepared for Smudge to come any day now but hoping he stays put at least till the end of this week, when my cardiologist comes back into town. (And really, contrary to what my OB said on Friday, there ARE differences between 37 week babies and 39 week babies.)

I’ve been having non-stress tests (NSTs) and amniotic fluid indexes (AFIs) twice a week since 35 weeks and once a week since 32 or 33 weeks. 2 of the 3 nurses in the NST office have made a great deal of hubbub over any change in my results. I bought into it at first, then with more research realized they were basically making stuff up. And some of the things I’ve overheard them telling other women has been really frustrating. I’m beginning to wonder if one of them is just really dumb, or gets pleasure out of making pregnant women squirm.

My favorite was the nurse who was teaching a student and using my case as an example. I gave a little spiel on Marfan and my medications, and then the nurse told the student that I’m planning a vaginal birth after cesarean (VBAC). The student’s eyes got wide and she blurted “But is that SAFE?!” The nurse shrugged and replied, “Well, that’s what they’re telling us to do these days.” Then she smiled. “But don’t worry, they’ll be scheduling her c-section soon…41 weeks MAX but probably before then!”

This was at my bed side. I corrected her and insisted no, no c-section was being scheduled for me without a medical need, and 41 weeks is NOT a medical need. She just smiled, told me one would be scheduled, and left. I tried to give some more information to the student about VBAC guidelines and research, but she told me she’d heard about someone whose uterus ruptured and therefore would never consider one herself. Made me wonder how that will affect her patient care.

Flash forward to this past Friday. I got a great, normal AFI reading and settled down for my NST. I’ve learned how to read the basics of the results and keep an eye on the monitor. When I saw Smudge’s heart rate dip into the 40s I wasn’t sure whether to be concerned, or to just assume the heart rate detector thingy was acting up again. A moment later one of the nurses came in with a pulse ox machine though, took my oxygen level, and wrote “Maternal pulse ox 90” on the NST printout. I questioned her but got little information, other than that I needed to stay on the monitor for a full hour. After that time she returned and told me that although everything else looked good she’d need to confer with the doctor on the floor to see if I needed to head to Labor and Delivery for further monitoring. Then I was told the doctor didn’t feel comfortable making the call herself, so my OB was paged.

He came and explained that there appeared to be a problem with the baby’s cord and I’d need a few more hours of monitoring to be able to tell how big of an issue it was. I should prepare for the possibility that I’d need to be induced with a foley catheter or have a c-section, and that there wasn’t much of a point in keeping the baby in me much longer anyway.

And since it’s taken me several hours to write this post and it’s now 2 am, I’ll write the rest tomorrow!

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