Week 28 Update: Third Trimester Drama brings some new caregivers

I haven't taken any belly photos this week, but here is one from last week:

The bump at 27 weeks

I postponed writing this update because I wound up getting so worked up with all of the changes that have happened in the last few weeks and I didn't want to needlessly worry anyone. 


So here's the scoop:



I had the appointment with the general practitioner on Tuesday, February 21st.  Her name was Dr. Dahr and she was really very sweet.  She agreed that I needed to be seen and evaluated by an orthopedic doctor and made a referral.  I had the second glucose tolerance test (GTT) at the same time.


I got a phone message the next evening from Judy, the prenatal nurse, letting me know that they were transferring me to high risk care.  I tried to call Judy back, but I got her voicemail.  I wasn't able to get Judy or Patty on the phone, which was pretty distressing.  I guess the figured that the folks at the Antenatal Testing Center would fill me in about the changes and why they were necessary.


I went to the Antenatal Testing Center on Thursday, February 23rd.  The ultrasound went much faster this time.  Peanut is bigger and easier to measure, and this ultrasound technician seemed to be more proficient as well.  The tech said "Boy, she looks just like her Dad!" right away. 

Here she is at 27 weeks.  Do you think she looks like her Daddy?

This time we met with Dr. Malik, who is an associate of Dr. Nath's.  She had a look at Peanut on the ultrasound machine but didn't really take any measurements on her own.  She was super speedy; I think we met with her for all of five minutes.  She said that Peanut's growth was normal and proportional and that she would wait four weeks to see us again for a follow-up ultrasound.  She couldn't (or wouldn't) answer any of my other questions, though she would say that the placenta is functioning normally despite the abnormal hormone profile, as evidenced by the baby's health and growth which means that she was getting good oxygen and nutrients.  She told me to hold the rest of my questions until my prenatal appointment.


Now that I am designated as "high risk", my care has been transferred to a practice on the campus of the hospital.  Monmouth is a teaching hospital and so it is staffed by resident physicians who are supervised by nurse-midwives and by faculty physicians, including the Maternal Fetal Medicine staff.  I won't be seeing Dr. Nath or his associates except for the days we need ultrasound done at the Antenatal Testing Center or if there is a complication that crops up when we are under the care of the residents.  This is the bad part of dealing with a teaching hospital.  The good part of delivering at Monmouth is despite the fact that it is a teaching hospital with lots of high-tech equipment and procedures, they are so midwife-friendly, the midwives not only practice right inside the hospital, they also are as integral to the residency program as the supervising physicians are. 

I had to do a full intake with the high risk folks on Monday, February 27th.  This was my fifth prenatal appointment.  Despite the fact that they are being really cautious, everything is still fine.  The residents wound up needing to leave to go for rounds and so one of the midwives, Maria, did the prenatal check-up.  My blood pressure continues to be normal (127/80, even with all of the added stress), the results of the GTT were normal (95, which is actually an improvement over the last one), my weight has been fine, my tummy is measuring right on target (fundal height of 30 cm- should be 26-30 cm), and Peanut's heartbeat was strong and regular.  The only current issues are the problems with my hip and the fact that my iron was still a little low.  I headed over to the hospital after that to get a shot of Rhogam to prevent any issues from the fact that I am Rh negative. 

The doctors and midwives have been frustratingly vague and playing a nice game of "pass the buck".  I think the real, true answer is that no one knows what is going to happen (which is the case with every pregnancy, really) and the uncertainty has them all being overly cautious.  Which includes protecting themselves from possible litigation down the road.  So the midwives tell me to ask the perinatalogist and the perinatalogist tells me to ask the midwives and most of my questions go unanswered.  I keep asking, though, because these things are important, and I have a right to be informed.  I would even accept "We don't know" as an answer, but not answering is not an option.  The one bright spot of the whole day was the prenatal nurse, Carla.  She was wonderful about keeping me informed and tried her very best to get answers from the doctors and midwives for me.  She is also extremely proactive and helpful, so I have an ally in keeping things on track.  She is going to make sure that I get an appointment to see the orthopedic specialist that the high risk doctors use and will keep pushing the doctors to answer my questions.  Right now, I don't even know who is going to deliver this baby now that things have changed.  All of this uncertainty is completely unnecessary.   

The good news is that none of this has affected the baby.  Peanut is healthy and active.  I am less happy, but that is honestly more due to the constant pain in my back, hip, and leg than to anything else, even the new stress of the change in doctors.  It is pain with a purpose, though, and I know it has an end point.  Just another reason to look forward to her arrival.  :)

I'll be heading back for another prenatal appointment with the high risk people on Monday, March 5th and I'll update you all then. 

Thanks for "listening"!