A Cautious WhooHOO!!

Yesterday I used Melissa's trick: I laid on my back with my hips elevated and had the kids talk and sing to the bottom of my belly. My two didn't get such a kick out of it as Melissa's two. But Wee3 did, it seems. Afterward my belly and pelvis felt different. Instead of a shelf, I now have a steep slope. And it just feels a little different in my pelvis area. Seemed to me that meant the baby had settled in. And hopefully head down!! The other thing I noticed was movement up under my ribs, something I had never felt before, just movements in the upper quadrant. So I was hopeful that meant longer reach and therefore legs up!

Naturally I poked and prodded extensively. Seemed to me that the lump I felt at my fundus was just too big and a little too soft feeling to be a head. But I couldn't find a head down low.

So I called Lucia to ask if I could pop by for her to check. Con todo gusto, she replied. She had a feel and at first said that it was the head at the top. Then she did more feeling around, and had to really dig but thought she finally felt the head deep in my pelvis. What it comes down to is that she can't say with 100% certainty but she is inclined to believe that Wee3 is now head down and well engaged in my pelvis. (!!!!!)

She mentioned that baby felt big... well no surprise there given that Eva and Micah were 8 and 9 lbs respectively. I told her I wasn't scared of a big baby. She didn't seem worried either. I feel good!

Praise God for today's special blessings: cooler weather and a very possibly head down baby!

A Little Worked Up

I'm feeling much better today, but the last few days I have been a little stressed. I've been trying, semi-successfully, to keep it under control. Then yesterday a friend suggested that perhaps I might have polyhydramnios (excess amniotic fluid) given that I seem large for dates, I have trouble figuring out baby's position, and baby has been breech. A reasonable suggestion, and one I appreciated her bringing up, from the point of view that it's something I would want to know before going into labour.

So I've been praying and I've been researching and I've been looking forward to today's visit with Lucia.

The prayers helped... by the time I got up this morning I was feeling much more peaceful.

The research in some ways eased my mind and in other ways worried me more. Many cases of polyhydramnios are for reasons unknown. Other causes could be any number of conditions of the central nervous system, heart or kidneys, in which the baby either can't swallow properly or produces too much urine. Whatever the reason, polyhydramnios can lead to premature labour/rupture of membranes, prolapsed cord, placental abruption... all very not good things. Signs of polyhydramnios include shiny, tight belly (doesn't describe mine), breech baby (because baby can float around so easily), difficulty identifying baby parts during palpation (I think I am just inexperienced and not gifted at this vs not being able to find baby parts. Neither Lucia nor Dr. Lopez has had any difficulty identifying baby's position), difficulty finding a heartbeat (never a problem), heartburn (not a problem), swollen legs (mine get slightly swollen, but not extreme and it only makes sense that it is heat related given the heat here), varicose veins (not a problem).

Of course the idea that my baby might have an abnormality is stressful, and the idea that it might cause problems during birth is disconcerting to say the least. But the good news is that most women with polyhydramnios go on to deliver healthy babies.

We saw Lucia today. She palpated and quickly discovered that the baby was full on head up. She laid a rebozo (a rectangular piece of fabric traditionally used as a shawl or a baby sling) on the floor and had me lay on my back on top of it. She and Andrew each took an end, lifted my bottom/middle about a foot off the floor, gave it a little shake to disengage the baby from my pelvis, then wiggled me by alternately pulling on the ends of the rebozo, for about 10 strokes. Lucia checked after that and baby had rotated a quarter turn! Cool.

She didn't express any concerns about my size or how my belly felt, and she seemed fairly relaxed about baby's position. Obviously we'd all be reassured if baby were in a favorable position, but it is good news I think that baby doesn't seem to be locked into breech.

I asked her a little more about everyone's role at the birth. Lucia will be a doula. She will be concerned with my emotional and physical well being- comfort measures, making sure I'm hydrated and fed, etc. She will spend the most time with us. Dr. Lopez will be there, I assume from the time active labour gets well underway, for medical support. He will watch for any developing complications, suture if needed, etc. The pediatrician will be called when the birth is imminent, and will be there for the baby, to give medical attention to the baby if needed, and to perform the newborn exam.

I'm feeling a little better about not having met the pedi yet. Andrew is totally on board with what I want and more than willing to run interference if the pedi (or Dr. Lopez for that matter) wants to take baby before I'm ready or perform some sort of intervention I don't want.

I did mention to Lucia that I don't want the baby vigorously cleaned up after the birth, just covered to stay warm (like that will be a problem if this heat continues!). I've seen lots of birth videos where baby is briskly rubbed, wailing, and imagine that is not a happy time for baby. There's no harm in leaving the babe vernixy and even a little bloody. In fact, from what I understand the vernix is terrific skin conditioner. :)

We talked also about home birth supplies and I'm in pretty good shape. I got the absorbent bed pads at the store yesterday, and Lucia told me that Depends make great postpartum pads. She thought we might be able to get the pharmacy at the entrance to our area to have an order ready for pickup if we need it, so we wouldn't have to purchase things we wouldn't necessarily need. She told me to get a 30cm wide tensor bandage for belly binding so that answers that question. I also tried the plastic sheet yesterday and it covers the bottom half of the bed completely so I think that will be good.

We'll have our care provider meeting here at the house a week from Sunday. I will be 36.5 weeks. A little closer than I'd like but I think it will be fine. It gives me a little more time to get the house a bit more organized as well.

So, I left feeling pretty good. I'll still be curious like crazy to know about baby's position but there are things that we can do to encourage baby to turn vertex and then I'll just have to leave the rest of it in God's hands.

35 Weeks!

Your baby weighs about 5 ½ pounds now and measures about 18.9 inches long. As you know each baby has a different weight and length at birth, so these measurements are just an average. Now your baby will start it’s most rapid weight gain, adding ½ to ¾ of a pound every week until they are born.

You may be able to distinguish body parts such as a head, hand or foot now that your baby is getting larger and your uterus is getting thinner. Baby’s hearing has completely developed now and the lungs are very close to being complete and ready for birth.

The kidneys are fully developed and the liver is able to process waste products. Fat is continues to accumulate at a rapid pace now, which will help your baby stay warm after they are born.

When you visit your health practitioner now they may begin to exam your cervix to see how ready it is for delivery. If you are not having a home birth, have your overnight bag packed and ready so that when your labor starts you have everything you want and need ready to go to the hospital or birthing center.

WOW! I am only two weeks from full term!! My word.

Gotta get the birth attendant stuff figured out. I think my main question mark is just about the pediatrician. I would like to meet the person I'll be dealing with, work out any points we disagree on, and understand what exactly the pediatrician's role is at this birth! I am also curious to know whether someone will be doing home visits after the birth or if I'm going to have to haul baby and me down to an office somewhere. I'm not overly worried about this one; even our vet did home visits so I'm sure that baby doctors would be willing. But still, I just want to know.

HA! Sure I should be able to distinguish baby parts! I am completely useless at that. Not that it stops me from trying. But I can't make heads nor tails of it [pun very intended].

There will be no pre-labour cervical checks going on here. I'm not sure why they get done anyway; a woman could walk around 3cm dilated for weeks, or efface and dilate like crazy in a the blink of an eye. If I get my way, there will be no checks. I might consent to one but honestly I'd just rather not. They are uncomfortable, and I don't care to take the risk of infection when I don't see an overwhelming benefit. I'm ok with being in the dark about my progress, dilation-wise. I think there are plenty of other signs to indicate how labour is coming along.

I've been thinking about getting a few things together for the birth. I have a plastic sheet which could work on the bed, though it's only a double and it's fitted so that might be annoying. I should pull it out and figure out whether it will work or not, and buy a cheap shower curtain if it doesn't seem good. I think we will then cover that with a set of Eva's sheets which have gotten holes in them. That way if they don't wash clean I can just throw them out without worrying about it. I guess I'll have to buy some pads too. And I plan to bind my belly after birth- I should buy whatever it is I'm going to use to do that. Maybe Lucia can offer a suggestion. I did a little research on the belly binding thing and there don't seem to be any drawbacks (except perhaps feeling hot!). I asked Tara's midwife about it and she was all for it. I remember how I kind of craved some kind of abdominal support after my babies were born; felt like everything was floating all free in there. And of course there's the added aesthetic benefit.

Anyway I'm still feeling great. Hot, but great. I was reading The Pregnancy Book by Sears and Sears, and it said that this month I may be feeling sore and tired of dragging my big body around. But I really don't. I'm slow, sure, but I'm comfortable. Sleeping isn't a problem, and I don't have any discomfort anywhere. I'm thinking part of it is luck of the draw, and the other part is the good eating and exercise. Whatever the reason, I'm grateful. I know that pregnancy can be very difficult and uncomfortable for some women.

GBS Decision Made

This Cochrane review concludes that administering antibiotics to all GBS positive birthing women isn't an evidence based practice. My mind is made up now regarding GBS. I won't ask for testing, but I won't refuse if Dr. Lopez orders it. If I'm found to be GBS positive I would pursue some natural remedies to reduce my bacteria counts. (I'm already taking vitamin C daily and like to include garlic in a fair amount of our cooking, two of the suggestions for reducing GBS colonization.) However I wouldn't accept antibiotics unless I fell into the risk category.

Intrapartum antibiotics for known maternal Group B streptococcal colonization

Women, men and children of all ages can be colonized with Group B streptococcus (GBS) bacteria without having any symptoms; bacteria are particularly found in the gastrointestinal tract, vagina and urethra. This is the situation in both developed and developing countries. About one in 2000 newborn babies have Group B streptococcus bacterial infections, usually evident as respiratory disease, general sepsis, or meningitis within the first week. The baby contracts the infection from the mother during labor. Giving the mother an antibiotic directly into a vein during labor causes bacterial counts to fall rapidly, which suggests possible benefits but pregnant women need to be screened. Many countries have guidelines on screening for GBS in pregnancy and treatment with antibiotics. Some risk factors for an affected baby are preterm and low birthweight; prolonged labor; prolonged rupture of the membranes (more than 12 hours); severe changes in fetal heart rate during the first stage of labor; and gestational diabetes. Very few of the women in labor who are GBS positive give birth to babies who are infected with GBS and antibiotics can have harmful effects such as severe maternal allergic reactions, increase in drug-resistant organisms and exposure of newborn infants to resistant bacteria, and postnatal maternal and neonatal yeast infections.

This review finds that giving antibiotics is not supported by conclusive evidence. The review identified four trials involving 852 GBS positive women. Three trials, which were around 20 years old, compared ampicillin or penicillin to no treatment and found no clear differences in newborn deaths although the occurrence of early GBS infection in the newborn was reduced with antibiotics. The antibiotics ampicillin and penicillin were no different from each other in one trial with 352 GBS positive women. All cases of perinatal GBS infections are unlikely to be prevented even if an effective vaccine is developed.

Fundal Measurement

I just did a quick fundal measurement (distance from the pubic bone to the top of the uterus). I measured 36cms, which is nice and close to my almost 35 weeks gestation. Which means that my uterus really is not so overly big as it looks.

I have a theory.

My theory is based on the fact that when I'm hungry I feel my stomach growling at about belly button level. In my previous pregnancies I have felt them more at diaphragm level. So my theory is that with this pregnancy my uterus hasn't pushed all my guts up under my ribs like in the past... some of them are hanging around behind my uterus. Therefore making it stick out more.

Just a Teeny Bit Worried

I spoke to Lucia the doula this week, trying to organize a gathering at our house with all the care providers so they can see the space, so I can meet the pediatricians, so Andrew can meet everybody, and so any outstanding questions can be answered. But Dr. Lopez had his surgery on Wednesday, which is great, but means we'll have to put off the big meeting for a couple of weeks. Which brings us quite close to full term.

So I'm feeling a little uneasy leaving this so relatively late. Also, Lucia said that Dr. Lopez had mentioned that the baby was breech when he saw me and she wants to take some action in that department. She wants me to crawl around for 5 minutes three times a day, and she wants us to come by so she can use her rebozo technique to encourage the baby to turn. All very good stuff, of course. But the fact that she is concerned gives me a tiny bit of stress. Add to this that I cannot tell what position the baby is in, which is so frustrating! I have been poking and prodding the baby and probably annoying him or her like crazy but I still can't find a head or a bum.

I'm also a little frustrated, because it's not like I spend my days slouched back on the sofa. I am conscious of my posture, and at yoga we do a lot of hands and knees and downward dog, both of which are positions which are recommended to encourage a baby to turn head down.

So I will do my crawling, I will do inversions, I will continue going to the pool, and today we are hopefully going to get over to Lucia's to do the rebozo thing.

34 Weeks

Your baby now weighs about 4.9 pounds and measures about 18.4 inches long. Your baby is fully developed at this point, but is growing and gaining weight now. Baby’s chances of survival outside of the womb are very good now, with only the lungs needing further development.

Baby is probably in the head down position now and the skull is soft so that baby can move down the birth canal during birth. Pressure from the baby being head down can make you have to urinate frequently.

The immune system is continuing to mature now and preparing to fight infections.
Because your baby is rapidly building up fat, little dimples are forming at the elbows and knees. Creases are forming around the wrists and neck. Bones are continuing to harden now and the waxy substance covering your baby’s skin, vernix, is thickening.

There are several prenatal tests that your health practitioner may recommend at this point. One that you need to ask for, if your doctor or midwife doesn’t suggest is, is the GBS (or Group B Step) test. This test screens for harmful bacteria that you can pass to the baby at birth.

Still battling the heat but feeling otherwise good. Getting into a bit of a routine now. It includes spending time every day with my feet and lower legs immersed in the kids' pool, The Body Shop Peppermint Foot Spray, a rest in the afternoon, daily after dark 30 minute walk (it's still hot out, but at least it's not blazing hot). Twice a week instead of the walk I go to yoga from 8:30-10:00pm. I found the right class for me- nice and slow and gentle, mostly stretching and balance positions. I love balance positions. I feel like I make up for my lack of flexibility with my great balance. But can you believe they turn off the A/C during classes?!? Talk about Hot Yoga. So I just take it easy, don't push it, and fan myself a lot. My face must get so red. The advantage to doing yoga when it's hot, I must admit, is it gets the muscles and joints nice and loosey-goosey. I come out of there feeling quite relaxed.

Dr. Lopez didn't order a GBS test, but I suppose he might at our next appt (~37 wks). Maybe it's not standard here in Mexico? Part of me doesn't want to open the can of worms if it's not standard, but part of me thinks it would be wise to request it. Well I have a month to think about it and research it.

Micah told me today that he wants the baby to be a girl and so does Eva. Eva usually refers to the baby as "she", though if you ask her she will say she thinks it's a boy. I asked Eva the other day why she had changed her tune about the baby being a girl. She said because I told her that when the belly sticks out to the front it's a boy, and when it sticks out to the sides it's a girl. I took the opportunity to explain about old wives tales and how that might not be true.

I'm feeling good about this home stretch. I am glad to be more disciplined about eating and exercise again and most of me is looking forward to how this birth will unfold. Sometimes I wonder if I realize/remember just how intense active labour is. I know so much more now! So I think I will be able to relax all that much more than my first two births, and that will make a big difference. But who knows what will happen?? God may have other plans for this birth. Maybe even to give me insight into what it's like to experience complications. So we have been praying more than ever about this birth. God knows my/our hearts' desire, but we surrender it to Him and accept what may come.

Still agonizing over names. Nothing new there. We never had "aha!" moments with Eva and Micah's names either.

Doctor Appointment

I had an appointment with my OB today. I took Eva with me and he seemed glad to meet her. Eva was a little shy but I'm glad she got a chance to meet him. She tried to hear the heartbeat with the Pinard horn but I guess the baby had moved since he heard it in that location. I'll bring Eva along again next time and hopefully she'll be successful then.

Let's see.... baby's heartbeat was 139.... and I have gained about 30lbs according to his scale. Can't compare to my scale since my scale seems to be on the fritz. As much as both Andrew and I would like to believe what it says, I'm pretty sure Eva hasn't lost 10lbs.

What else... reflexes are good. Hm, he didn't take my blood pressure. I have some edema (swelling). I knew that... I have noticed that my rings are a little tighter and that my ankles aren't quite so slender. But I am pretty sure it's nothing more than the heat. Edema can be a sign of preeclampsia, a very dangerous condition, so it's important to keep an eye on it.

He has a herniated disk and is going in for back surgery at the end of July. I will go see him again in a month. I hope his surgery goes well and he's recovered by the time I need his services! The last thing I want at this point is a change in caregiver.

He ordered a a urinalysis and couple of blood tests including the coombs (which tests for Rh sensitization). He mentioned that he didn't think the prenatal Anti-D vaccine would be necessary and I was so glad that we agreed. That's pretty much what I had concluded from the Anti-D in Midwifery book I bought last month. We talked about how the baby's blood type would be determined and he said he would do his best to get a good sample from the cord/placenta but if he couldn't then we'd have to take the baby down to the women's hospital so the NICU staff could draw some blood to have it typed. I'm not excited about the idea of taking a brand new baby out, especially since one of the benefits of the home birth is cocooning at home, but I do agree that it's important to get the blood typed as soon as possible. There is about a 72 hour window for applying the vaccine, but sooner is better in the case that fetomaternal hemorrhage occurred during birth. Which is difficult to determine, therefore the Anti-D is recommended if the baby is Rh+.

Baby was in breech position when he palpated my belly, but constantly on the move. Still very much free floating. He encouraged me not to worry that baby was breech right now because there is still lots of time. I appreciated that. While he didn't measure with a tape, he commented that my uterus isn't overly big. I think what's going on with the big belly is that rather than expanding to the sides or upward it is expanding outward.

I asked if he is comfortable with vaginal breech birth and he is!!! What a pleasant surprise!! It would have to be in hospital rather than at home, but that's all good. What a relief to know that a breech baby wouldn't automatically mean surgery like it so often does in Canada and the US.

Dr. Lopez wants to do an ultrasound at my next visit to double check the position of the placenta. Less than a minute, he said. I asked him wouldn't there be other signs, like pain or bleeding, if the placenta were low lying? He admitted that is usually the case but did say that it's not always true. I told him I'd do a little more research and think about it. He nodded knowingly and said he knows what that means... when his wife says, "I'll think about it," that means no. Heheh. Anyway he said he would never force something on me that I don't want, and I appreciate that. I will consider it carefully though.

He told me that the team is very excited about my birth, and they have high expectations of it. I pray it will be a wonderful experience for all of us.

Mask of Pregnancy

So far I have gotten away with no stretch mark or spider/varicose veins. My linea negra is very faint. But chloasma, also known as mask of pregnancy, is really kicking into gear. I had it with Micah too. The hormone changes of pregnancy, especially paired with sun exposure, cause darker brown areas on the face. I wear moisturizer with sunscreen daily, but don't usually wear a hat. Interestingly, I got much more sun exposure in Canada than I ever do here which I'm sure had something to do with how much more visible it is now than before our trip. The good thing is that after the hormones calm down a bit and with some time and normal exfoliation, it pretty much fades away. At least it did after my last pregnancy! So I'm not going to sweat it too much.

Belly Mapping

Spinning Babies is a cool site. It is a "unique, step-by-step approach to Optimal Fetal Positioning. Certain positions of the baby make labor easier than others."

There is a section called Belly Mapping which a mother can use late in pregnancy to try to determine baby's position on her own. I've been poking around a bit and I haven't quite got it figured out, but it's nice to have a resource to reference.

33 Weeks

Your baby now weighs about 4.4 pounds and measures about 17.8 inches. Baby will gain one third to one half of their weight during the final weeks of your pregnancy. The amniotic fluid is now at it’s highest level and will stay at this level until your delivery. Your little one may have now settled into the head down position; however, some babies do not do this until later in pregnancy.

The baby’s skull is not joined and is very pliable. The brain is rapidly growing now and increasing in size. Fat is rapidly accumulating and changing the color of your baby’s skin from red to pink, the skin appears less wrinkly as they continue to accumulate this white fat.

Because your baby is rapidly gaining white fat and weight at this point you may be gaining weight more rapidly than in the past as well. Continue to eat right and exercise as you can to help your baby grow and develop at a normal pace. Now may be the time to decide if you will circumcise your little boy after his birth. Continue to plan the details of your baby’s arrival including your birth plan the details of the nursery for when they come home.

Can you believe how much weight this baby will put on before he or she is born?

The nursery, AKA our room, doesn't need much work. I will wash and organize all of my marvellous new diapers. I will wash up a few newborn outfits, gender neutral and maybe a couple of each gender specific. I've asked my Mom if she would wash up the whole bin of appropriate clothing after baby arrives. We will pull out the change table, Amby Baby and set up the playpen with bassinet. I don't expect to use the crib for quite some time. I'll do most of that stuff in about a month. Most of it. The diapers I will do very soon, because I am SO EXCITED about them!

Regarding circumcision, if we have a boy he will remain intact. Check out this quite comprehensive blog post on the topic.

I am feeling good! Any complaints I have are fleeting- like yesterday while we were grocery shopping my hips were sore. By later in the day that wasn't a problem. Last night I had restless legs but after I got up and had a glass of water they settled down.

Emotionally I'm feeling good as well. I have had peace about this baby for quite some time now and I am grateful. Every once in a while I find myself considering getting stressed about potential undesirable situations (like breech baby) but I have been able to give those thoughts and the future over to God and regain my peace.

It's kind of entertaining to guess what position the baby is in... Lately there have been hiccups almost every day and mostly they are down low so I think baby is usually head down, but not always. There still seems to be quite a bit of room in there because I can feel big movements from time to time.

I think we may have settled on a girls name- first and middle- and there is one boy middle name that we agree on. But we're still at a loss for a boy first name.

Micah tells my belly, "I love you baby!" many times a day. When he feels sad he likes to hug my belly. He likes it best when it's uncovered so people occasionally get a glimpse of its full glory when Micah is sad in public.

I know seven weeks is going to pass quickly! I am consciously enjoying and appreciating the current status of our family. It will be forever different once there are five of us. This is a wonderful time of anticipation for all of us.

Cooler Weather Makes All the Difference!

The weather has cooled down the last couple of days and I am feeling quite spry and spunky! Here I thought it was the advancing pregnancy that was slowing me down so much, but in fact it was mostly the heat wave! Also I've been sleeping better which definitely helps.

32 Weeks

Your baby now weighs about 4 pounds and measures about 17 inches. If you’re feeling kicks in your ribcage it probably means that baby has finally moved into the head down position that 96% of babies are born in. Don’t worry if this hasn’t happened yet, you still have a few weeks left for baby to move.

During baby’s awake times their eyes are open and looking around. When they are sleeping their eyes are closed. Eye color is usually blue right now, but this will change with exposure to light, and then it can change again a few months after birth.

Little boys testicles are descending into the scrotum now. Sometimes this doesn’t happen until after birth, but this condition usually corrects itself. Baby’s immune system is starting to develop now and sometimes the fingernails are so long that they will scratch themselves.

White fat is continuing to accumulate now. This helps baby’s skin appear more pink and diminishes the wrinkly appearance of your little one’s skin.

If you haven’t already gotten a list together of the things you need to take with you to the hospital you should start now. Ask your health practitioner what signs to watch for to indicate you are in labor and when they would like for you to call their office. Be sure and ask what the procedure for contacting them is once you think you are in labor.

Whoohoo, I don't have to pack a labour bag or worry about that uncomfortable drive to the hospital!

I am slowing down lots! Still feeling good, but definitely feeling more "pregnant" than even a few weeks ago. I walk so slowly! It's not hurting or even uncomfortable, it's just that my body doesn't work the same. It's been quite hot here and I am feeling it. I'm glad to report that I haven't noticed any edema though.

I had my first uncomfortable baby movements the other night. The ole feet-in-the-ribs trick, and a bunch of weird kicking on the side. I was trying to sleep so I just rolled over onto that side and that took care of it.

We still haven't decided on any names. We'll have to make that a priority soon.

Addendum to 31 Weeks

I forgot to mention that the snoring has begun. When I was pregnant with Eva, my snoring was so bad that Andrew slept in the basement for months. I thought that it was a weight gain thing. Well, apparently that is not the only factor! I actually hear myself snoring as I drift in or out of sleep and I can tell you the situation is not good. I wonder if Andrew will be able to ride out these last couple of months alright!