Tuesday, November 18, 2008

Bedrest Chronicles

I went to the doctor again yesterday for a nonstress test, during which they hook you up to the monitor and watch for the baby's heart rate to rise with her movements (called a reactive strip). Last time it took a bit of time for them to collect the data they wanted, so I asked what I should eat or drink next time to help it go faster. The nurse said to drink something cold right before, like orange juice, and eat an hour before. Well, orange juice has always upset my stomach due to the acid content, and unfortunately it didn't work out to time my meal for an hour before, so in a rush I went through the drive through on the way to his office and opted for a cold chocolate shake. Boy, she liked that! LOL She was shaking, rattling, and rolling in there. Didn't take long to get the data at all.

I lost four pounds since last Thursday. At first I panicked upon seeing the number, but then I realized it must be that bedrest cuts down on water retention. I noticed my ankles were no longer swollen, and my face seems less swollen. Before I was on my feet constantly and I knew I was retaining a lot of fluid. I'm still drinking the same amount (about 3 to 4 (20 oz.) water bottles daily).

I go in again on Thursday, this time for a nonstress test and another ultrasound. I asked him if I should expect the baby to gain about a half pound a week (that's what I've read). He said that is what the books always say, but that if it were true babies would come out as giants. He thinks a quarter pound per week at the most should be expected. That doesn't really make sense to me. The average baby is 7.5 pounds at 40 weeks, and between 5 to 5.5 pounds at 35 weeks. Don't they have to gain up to a half-pound a week, to be around 7.5 at birth? It must be that the ultrasound weights are off more than we know.

His comment also leads me to question the wisdom of letting the baby stay in the maximum amount of time, given the blood pressure concern and the fact that it could go into preeclampsia, and/or it could lead to a detached placenta. The blood pressure medicine is working less well now. Its purpose is really only to buy time. It isn't a cure for PIH.

Timmy weighed 5.9 pounds at birth and was 10 pounds about 6 to 7 weeks later, just from breastmilk. Couldn't I fatten up baby better with breastmilk, if the womb only puts on a quarter pound a week at most? I decided this is compelling enough to ask him about the risks of inducing at 37 weeks (considered full term). I will be 36 weeks this Friday. My California doctor was more cautious about preeclampsia. His feeling was that one should always expect PIH to turn into preeclampsia, and that delivery should occur between 37 and 38 weeks if possible, to prevent further problems. This current doctor believes more in letting baby stay in as long as possible, barring an actual emergency. I want her to stay in as long as it takes for her to be able to suckle, swallow, and breathe all at the same time. Having the physical maturity to manage those three functions allows them to go home soon after delivery; usually this maturity occurs by 37 weeks. I believe that is why 37 weeks is considered full term. After 37 weeks the function of the womb is mainly to put fat on the baby.

I regret that she is on this blood pressure medication, and I hate the fact that the bedrest is putting stress on our family (my husband in particular). There is no evidence that bedrest improves outcomes. I have been put on it four times since Dec. 2001 (with each pregnancy). Current research is still showing no statistically-significant improved outcomes, even though the blood pressure numbers always improve when one is lying on the left side. I don't really understand it, but I do what I'm told as much as possible. My poor husband is really going out of his mind, though. Since he is so cranky, the kids are starting to get cranky. Putting up with each other's crankiness is part of learning to love unconditionally, forgive, and extend grace. It is certainly good for all of us in the long run. I get that part. This is primarily the reason that God allows hardship in our lives. It grows us in ways we wouldn't be able to orchestrate ourselves. And as we grow in love, we are better instruments for God's work.

In other news, I decided to e-mail that homeschooling mother of eight from my homeschooling group. I don't know many large families, and I really wanted to pick her heart and brain a little about Christian family planning into the forties. I was shy about writing, since I have never actually met her, but homeschooling mothers are a tightly knit group, generally speaking. I'm hoping she won't mind my questions. It happens to be a Christian homeschooling group, so she is probably familiar with the Titus 2(Biblical) model of women helping women.

I have pictures to post, but will have to get to that later today.

1 comment:

Evenspor said...

I would think that in a situation like this, induction between 37 and 38 weeks would be the thing to shoot for, but I'm not an expert. As the for baby weights, if someone asked my old doctor to predict the weight of the baby, he would say, "Seven pounds - and I'm always within three pounds," so I don't think the ultrasound is that accurate. I think Beeper gained two pounds just during his last week in there (he was born at 9 lbs, 3 days after his due date).

And I am sure the other mom will be happy to talk to you.