We’re now past 2 months, and I feel like we won’t be knocking on wood to talk about the challenges of the past year. Madeline proved to be quite a roller coaster when compared to our pregnancy experience with Ella. From a few days after the 18 week (gestational) ultrasound until after Madeline’s 2 week (after birth) appointment, we’ve been expecting the worst.
A few days after our 18th week appointment (for Michelle), she got a call from the genetic counselor at Kaiser who had some concerns about a bright spot in the Madeline’s bowel. I got a mysterious phone call from Michelle that was so out of character that it took me a few moments to realize that something was wrong. I left work to pick her up in the park outside work and we drove home in choked up silence. We spent the afternoon trying to understand what the spot meant, and whether or not we should chase the dragon of testing and observation or bury our heads in the sand and just accept what we would be given. The echogenic bowel meant that we were potentially looking at downs syndrome (and other trysome defects), cystic fibrosis, cytomegalovirus, blockages, hirschbergers, and other minor players. But it was 70% likely that there there was nothing wrong. This was a mild point of contention between Michelle and I because I was of the opinion that 70% were good odds and since we’d not do anything to the pregnancy, why drag ourselves through the torment. Most of all, I think I was upset that this time, I wasn’t scared shitless of the prospect of a baby and this just meant that there was something that wouldn’t quite allow for the joyous anticipation of number two.
After blood testing, family history, genetic counseling and a huge amount of internet sleuthing, we found out that Michelle had cytomegalovirus, or CMV in the past. Her “numbers” suggested that it was prior to pregnancy but no one could say with confidence that we shouldn’t worry. (The 2-4 hour waits to see the doctor and ultrasound techs certainly gave us the time to.) Ultimately we were tied to a 2 week schedule of wait and see. Not much happened, though the spot got lighter as time passed. By December, the spot had become inconsequential, possibly because of meconium in the bowel, and possibly because it wasn’t anything of concern. (At times, this all seemed like a bunch of meconium..)
Anyway, by late December things looked good and we were starting to relax a little. However, our first appointment in January came with a shock. Michelle’s amniotic fluid was low and she’d need to be on bedrest for the next few weeks until term. We expected to have another month to wrap up loose ends, but the doctor said that baby may need to come out at any moment. Until that time, we’d be back to the doctor every couple days to recheck fluid levels (always with a packed bag). Luckily, Michelle’s resting and uber-hydrating worked and the fluid level went back in to the OK zone.
On the 4th of these checks, we dropped in expecting another in and out appointment (I had a presentation at 11) but were surprised when the fluid level had again dropped. That and a lower than normal heart rate caused the doctor enough concern that she scheduled an induction… for right away. We were both kind of in shock, because the baby was early and we hadn’t brought anything for a stay this time. But baby was at least to 37 weeks and the machine said she was over 5 lbs, so we had some comfort.
I ran home and repacked our scatter stay bag, called work, and rushed back to the hospital, going much faster than needed. It was the only time I could say “My wife’s having a baby” if I was pulled over. By the time I got back to the hospital, sanitized my hands for the first of 10,000 times, and found Michelle in a delivery suite, she’d notified the cavalry and people were all in motion. Unnecessarily as it turns out, because induction took all of Thursday, all of Friday, and until the wee hours of Saturday morning to take effect.
So we read, we watched non-stop coverage of Miracle on the Hudson, and played solitaire. And Michelle, who hadn’t eaten a breakfast yet, couldn’t eat anything. So she sipped broth, protein drink, and lots of cran-grape juice. Luckily she was able to eat solids during the break between induction attempts. Finally, contractions began in earnest and Madeline sprung forth on Saturday morning in all her beauty and perfection. To an almost immediate dusky episode. The nurse (Jana) moved in to quick action and bulbed out a bunch of fluid and things quickly returned to, well, not quite normal, but you know what I mean.
It turns out her rapid movement through the birth canal meant that she was still carrying a bunch of amniotic fluid in her stomach. So she tended to spit it up. But she was beautiful and looked alarmingly like Ella.
We moved over to post-delivery for a stay and again had a wonderful nurse who took great care of us while making us feel competent about being parents since we hadn’t killed the first one. Madeline did have another dusky episode which we pulled the red help cord for, shortly after having accidentally pulling it when moving the bed. But again, things seemed OK with the exception of a medium-high bilirubin level. Still, after some amazing negotiating and string pulling on Michelle’s part, we were discharged to return home to our other little girl.
The first night went ok, but Madeline ended up spending the second night in the special care nursery which I’ve already written about here.
After all that we still had a few issues with diet (no pizza, no onions, no garlic, but luckily dairy is ok) that resulted in severe gas, projectile vomiting and delayed “movements,” but now seem to have everything figured out. Madeline is doing great. She’s nearly 11 pounds after 9 weeks and starting to smile and look at us like she has no idea why we were concerned.
Michelle and I deal with stress differently. She used it to to learn as much as she could about echogenic bowel and everything it could potentially mean for our child (and her sibling). That’s a lot of information, especially with the access that Google Scholar allows. We’re very fortunate that she found this article, and that it described what was ultimately our situation. Obstetrical sonography: the best way to terrify a pregnant woman by Roy A. Filly MD. It describes the conundrum of echogenic bowel, both for the physician and the parent. And the conundrum of having machines become the truth of your child’s health and growth.
I’d not have done this much differently, but it was easy to forget that we started with a 70% change of nothing being wrong and narrowed it down with each test. We never did an amniocentesis, which would have actually potentially widened the odds that the baby might be injured, but there was sort of this system in place that you couldn’t really escape once you started. For better or worse.
In the end, I can’t be more grateful for the help, guidance and care we received – both from family and the doctors. Now we have our two beautiful girls and are glad the whole pregnancy thing is behind us. The uncertainty and stress seems like a bad dream.