Friday, September 23, 2011


Well, I had my first official OB visit.  Here are the stats.

I was 10 weeks.  I'd lost 2 pounds. My blood pressure was 115/80 (high for me, but they'd had me waiting for almost an hour so I was a bit miffed).  We could not get the heartbeat on Doppler though I swore he got it last time at 8 weeks.  I told him it was OK, I was thinner in the midriff back then. 

Then I suggested he get the nurse to roll the portable ultrasound in.  Who doesn't like to play with their gadgets?  He was shocked I hadn't gotten an ultrasound earlier for dating purposes and because of my ADVANCED MATERNAL AGE.  I am pretty sure my AMA is going to be a theme since everyone kept bringing it up.  Anyway, there is one singular embryo in there (in 3 days, I will begin calling Muse a fetus).  I did not hear a heartbeat, but I saw it.  I also saw a lot of wiggling and shaking.  It took me a while to put my amateur sonographer hat on.  It's been 3 years since I looked at an ultrasound.  You get rusty.

Anyway, I also saw a spine, feet, legs, arms, hands, and most impressively: two hemispheres of brain.  I was offered a regular ultrasound and a fancy-pants ultrasound at the perinatalogy practice for the NT scan (I could have had both of those, in fact).  I turned down the regular ultrasound since scheduling these things is difficult, and it's less than 2 weeks until the NT scan (which is really no big deal this time around.  Last time it was an ordeal finding someone locally who did them.  This time, they gave me a paper of two places they use who do electronic records sharing.  The march of's good for something.).

I am to continue with the progesterone until 12 weeks (and getting that script filled is a nightmare, but I will spare you the story of the (young) pharmacist who told me she had called other pharmacies to find out how to make the suppositories).  There is scant clinical evidence to say that the progesterone supplementation does anything, but no one wants to stop it since it doesn't hurt.  And good luck finding double blind subjects for your trial who are willing to take the placebo (kind of how they are having a hard time doing studies on whether bed rest is a good thing).

The doctor told me I'm his favorite patient because I have a good feel for statistics and risk.  We talked about placental issues (accreta and previa) because I am at increased risk for both, but again, a doubling of the risk is still a small absolute risk.  At the ultrasound, I will ask where in the uterus the implantation is so that I can prepare myself.  I'm hoping for top of the uterus toward the rear because that minimizes all kinds of bad things and means I will feel kicking earlier.  Oddly, the risk of placenta previa is 1 in 200, regularly.  I've had it before, I am over 35, and I have had two previous uterine surgeries, but my risk is still only 3% according to the March of Dimes. 

My personal risk of placenta accreta is probably on the order of 0.5%.  I've already given my doctor the go-ahead to perform the hysterectomy, if necessary.  He said accreta and before he could say another word, I said hysterectomy.  He was impressed.  I'm decisive and have no more use for my uterus.  Oh, and I don't really want to die. 

As to my advancing maternal age, my age-related risk of a trisomy (21, 13, 18, X, and Y) is 1 in 156 (probably actually higher than that as the number refers to pregnancies that are live births not miscarried or stillborn).  That's only about 0.6%, but we have screening tools for the trisomies, so I am going for the NT scan.  They will check CRL, NT, bowel (bright/not), choroid plexus (cysts/not), umbilical cord (number of vessels), and nasal bone (present/absent). I think I am also having blood drawn for the complete test, but I'm not entirely sure.  I do better with lots of information, but whether or not I am having blood drawn doesn't really matter unless any of the tests has the "wrong" result.

When I called to schedule the NT, the receptionist asked the reason for the appointment, and I said advance maternal age.  She actually replied, "Ohhhh, so you're a young mother then?"  And I was like what?  Did she just call me old?  I responded that I was actually, "a third-time mother."  Wow.  You would think she hears that every single day and would've learned not to comment at all.  In 1970, approximately 3% of babies were born to women over 35.  Today it is about 14%.  That's 1 in 7, so it's not like I am a two-headed hydra.  (Side story: my grandmother was first married in 1951 at age 38.  10 months later, she had my father-her first and only child-at age there's a woman who was a statistical outlier on maternal age and probably a circus curiosity at the time.)

**** The asterisks are my way of indicating a slight topic change.

After Bobo was born, I got rid of all my maternity clothes (and tiny baby clothes).  So, I have no clothes.  I went over to Goodwill and bought some tops and pants.  All-in-all, I spent about $30.  I was feeling very bad about spending that money (because I am so ridiculously cheap, thrifty, fugal cheap), but then I remembered that recycling clothing is a green alternative, and the $30 I spent there pales in comparison with the costs to have and raise Muse.  I still need pajamas and a dress for the holidays, but I think I can beg/borrow those. 

Some might ask why even both with pajamas...why not just wear your husband's sweats or no jammies at all?  I always wear pajamas.  I love pajamas.  And I get large.  Like very large.  Much larger than any piece of my husband's clothes.  And not just big like buy some 2X jammie pants big but pregnant with a future linebacker big.

I went to the baby shower of a woman once who was 7 months pregnant with her first and she said she just went out and bought some "really big" clothes a few sizes up from her normal size.  The dress she was wearing at her shower was supercute.  Then she mentioned it was a size 12.  My normal size.  *Sigh*  Anyway, she was young.  I'm sure she bounced right back in to her size 4 jeans.


  1. But could she solve a differential equation? That is what I mutter to myself when confronted with the young bikini clad women on my local beach.

    Of course I never ask them. Because what would I fall back on if the answer was yes???

  2. Ah yes, advanced maternal age. When we were about to start trying, we decided to speak with DH's doctors first as he had been previously told by another doctor that he shouldn't have kids. Of course, after my research, it seemed that there was very minimal risk (2-3%) that a mother who had a congenital heart defect would pass it on to her child. And a father passing it on to a child? Negligible.

    So, when we asked DH's doc if he could have kids, the doc looks at me and says 'How old are you?' I answer 37. And the doc says 'He's fine. You're the problem.' Alrighty! At least he was direct, I guess.

    But yeah, statistics was the only way I could decide what we would do with the results of the NT test. I mean sure, anything could happen. But I had to go with probabilities.