This week has been quite eventful to say the least. I feel like ever since I hit 28 weeks, I’ve been counting down the weeks I remain pregnant with this baby still inside. I made it to 32 weeks with relatively stable blood pressure and negative preeclampsia labs. I was never going to make it to my due date of May 14th, since I would have an induction for blood pressure regardless, but I’m still really hoping I can make it to at least 36 weeks without any complications that would land me in the hospital where I would deliver.
So spoiler: Everything is okay, but for awhile there this week it wasn’t looking very promising.
Monday: Hospital monitoring
I woke up, did All of the Things including checking my blood sugar, eating, meds, all that. My blood pressure before my medication was 139/80 which is completely normal for me. I took my BP medications and rechecked it an hour later and saw it was 145/78 and five minutes later it was 152/78. I also noticed I was having a slight headache. So this was of course concerning since I haven’t had this high of blood pressure since I was on the Procardia at 18 weeks. But still, it wasn’t that high considering my bottom number, my diastolic, was technically in normal range.
I said I would call my clinic if I got a second high reading since I didn’t want to get all jumpy for one elevated reading. Besides, the headache had gone away, and the baby was moving like usual, something that wasn’t the case when I had preeclampsia with Emelia.
I went about my day and rechecked my blood pressure around 11:30 am and it was 133/76. I had a slight headache, but felt like I couldn’t justify calling the clinic when I was getting a normal-for-me reading.
At about 2:30 pm I took my afternoon BP medication and an hour later rechecked and I was 145/84. Okay, fine. So I called the clinic and left a message for my care team. A PA called me back just minutes later.
“We should get you in here to check your blood pressure and run labs, though they won’t come back until tomorrow. Your other option is to go to the hospital for monitoring.” I asked her what she thought I should do, and she suggested coming in for an appointment, with the warning that I still may need to go to the hospital. I still had a very slight headache, but Pokemon was still moving fine.
I called my mom and she agreed to wait for Chris to call if they needed to come to take care of the girls who were still in daycare at that time. I packed a bag, not knowing what would happen, but history told me this may be the time when I’m hospitalized for the duration of this pregnancy. I told Chris I’d go myself to the clinic, and if need be, he would meet me at the hospital.
I drove the 30 minutes to my clinic, listening to my pregnancy affirmations in the car and trying not to overthink.
My blood pressure in the clinic was 137/85. Slightly more elevated than usual, but I’m used to so much higher when it’s preeclampsia. The PA I saw said she had some concerns that the labetalol I’m taking might be masking preeclampsia. She wanted to call the on-call doctor which was Dr. C. that night and talk it through. But, she said, she’s fairly certain they’re going to want me to go to the hospital to be on the safe side. She left and a nurse came to draw preeclampsia labs and recheck my BP which went down to an odd 121/84. I texted Chris that he should call my mom and start heading to the hospital.
They came back in and my BP was 138/80-something and I thought it was weird that it was going all over the place.
I kept telling myself this was still probably nothing, that my labs would be negative at the hospital and this just meant I needed a dose adjustment. My MFM doctor has said BP can naturally rise in weeks 28 to 32 and I was already on that cusp.
The PA came back in. “I have some bad news,” she said, “the hospital NICU is on divert and you need to go to [insert urban St.Paul hospital where I’ve never been before].” She shook her head, saying it was ridiculous because she didn’t honestly think I would be giving birth tonight. “I just want you monitored, but they won’t accept you.” This fucking hospital and their protocols. It wasn’t the first time I’ve experienced this since Emelia’s birth was littered with staffing issue protocols that left me with an enormous amount of anxiety including the pressure from the hospitalists to forgo the VBAC, slice me open in a C-section and transfer my baby to Children’s Hospital across town all because of “staffing issues on the weekend.”
So while it didn’t shock me, I still stared at the PA like, “You’ve got to be fucking kidding me.”
“And if this does turn out to be preeclampsia, and I’m at that hospital, then what?”
She looked apologetic. “Then you’d have to deliver there.”
“Without my doctor at a hospital I’ve never been to.”
Unfortunately, yes, she said.
But, she added, quickly, she didn’t forsee that happening. She just wanted me checked out for preeclampsia. She said even the on-call doctor was frustrated with the situation because she had told the PA it was ridiculous since she could check me out and care for me there, but no nurse was available for me.
We briefly looked into me going to the nearby smaller hospital where my doctor still couldn’t deliver at, but was way more holistic in care, but that got squashed when the hospital said they wouldn’t take me before 34 weeks since that was what their NICU was set up for.
All these people just assuming I’ll be giving birth that night with a premature baby. God, it was pissing me off.
So in the end, I didn’t have a choice and luckily, they were okay with me driving home to get Chris so we could go to the St. Paul hospital together.
I ate Mcdonald’s in the car since I was starving (I bet my blood sugar was sky-high after that one) and headed home.
The girls were stoked to see me and I talked with my parents for a bit while Chris packed his “just in case” bag. Olivia was upset that I might be in the hospital for a long time and I didn’t want to lie to her in case that was the case, but I tried to keep it light and tell her I was going to be taken care of and I hoped I would see her tomorrow morning. We said our goodbyes and were off, arriving at the hospital maternity unit a little after 7 that night.
The triage nurse who cared for me was really nice and said even if I had to be there to birth, they had a good team, especially since I already had one VBAC and their rates were 100% last month. Still. There was no way I was trusting another doctor to match my OB’s specific induction protocol he has, especially since I’m planning another unmedicated delivery. With my distrust of conventional OB care in general, I wasn’t convinced this would end in the birth I wanted.
Pokemon was doing really well on the fetal monitor and my blood pressure was mostly under 90 diastolic. I gave a urine sample and she took blood, and otherwise, we just sat there.
At about 9:45 that night, I got my blood pressure medications and baby aspirin and my labs came back negative, with my urine creatine/protein ratio at 0.1. Apparently, 0.3 is the threshold for preeclampsia, so it’s just slightly elevated, but my nurse reassured me that lots of people stay at this 0.1 for the rest of their pregnancy without any issues.
But I’m supposed to watch myself very very carefully and monitor for any symptoms.
It was such as relief to bust out of there and go home and Olivia and Emelia were so happy to see me the next morning.
Tuesday: First biophysical profile and non stress test
I had another bodywork session with my doula in the morning before meeting with the OB. I had been texting my doula all last evening, so she knew what happened, but we talked about focusing on myself and taking care of myself, and listening to what my body needs for these remaining weeks (and how fucked up hospital politics are).
I had my first biophysical profile (BPP) and non-stress test (NST) that afternoon before meeting with my favorite PA. Chris came with, even though it was a really long appointment, so he could see the baby again.
Pokemon was still head down and even gave up a decent profile of his face. I told the tech we never really got a good face or profile shot of him because of the way he’s always positioned inside.
His heart rate was about 128 and he’s roughly 5 lbs 5 oz, measuring a week ahead in the 76th percentile. His head I think is in the 55th percentile, but his tummy is measuring in the 99th. That, the PA said, might be due to gestational diabetes, which makes me feel really bad. I’m trying not to dwell on it so much since all I can do is control my diet going forward (my therapist will be so proud of me).
My BP was 119/80 and we agreed to not make any medication changes at this time. However, it may not be the last time I see the inside of a hospital for preeclampsia monitoring before the baby comes.
While I was hooked up to the machine for my NST (which went really well and baby did everything he was supposed to), we talked about a game plan going forward. If I can make it to 34 weeks, and my own hospital won’t accept me, I know I can try to go to the nearby smaller hospital which would be much better for my birth plans than the other St. Paul hospital. But to avoid my hospital refusing to take me for monitoring, my PA told me that the best thing I could probably do is just show up to the hospital next time instead of my OB calling ahead. That way they have to legally take me. And, she added, those staffing shortages vary shift by shift. Meaning, they may not have proper staffing for that current shift (NICU or otherwise), but could a mere few hours later. We just have to play their game and I told her I can manage to do that.
So, basically, if this happens again with headaches and blood pressure issues, Chris and I will just show up to labor and delivery and tell them we didn’t notify the doctor yet and they didn’t know we were coming. Stupid, but you gotta do what you gotta do. Who would have thought we would be dealing with this? I mean, you’re supposed to just go to the hospital you’re supposed to deliver at right?
Anyway, because of the fun we had Monday evening, she now wants to increase my OB visits to twice a week where I’ll do BPPs and NSTs, including preeclampsia labs until I deliver. I know it’s the safest thing, but ugh. So many appointments.
Thursday: BPP and NST #2
Thursday was BPP and NST #2 of the week. I arrived at 3:45 for the last appointment of the day since I needed to add on this second appointment on Tuesday which was last minute, and didn’t end up leaving this appointment until after 5:45 that evening.
First, the BPP took about 45 minutes to complete since Pokemon wasn’t doing his practice breathing (which the tech said wasn’t concerning, and they don’t start really prioritizing until 35 weeks, but we still had to sit and stare at the screen at his abdomen for a solid half hour waiting for breaths.) He passed the rest of the test with his big and little movements, and we saw a glimpse of his profile, but that was about it.
Then I went back to the exam room where I was hooked up for the NST and was told the PA would be in soon. Pokemon was asleep at the wheel and for the first ten minutes, he didn’t make much movement at all. And then he suddenly started wiggling and kicking. I think there was one time his heart rate dropped to 103, but the PA later didn’t say much about it. But I sat there on the table for a solid 35 minutes as no one ever came in to check on me. After 25 minutes, I started wondering why no one had come yet, and after 30 minutes my butt started to go numb from sitting propped up. At that point, I had been at the clinic for an hour and a half and was more than ready to leave (especially when it was my third visit that week).
Five minutes later, I said fuck it and unhooked myself from the machine, gingerly stepped down, and opened the door to the room. I found a nurse and said I had been hooked up for 35 minutes without anyone coming in and my butt hurt so I was done. She was apologetic and came into the room to look at the readout. Yes, she said, the baby was definitely doing well, and that the PA would be in soon.
I waited another few minutes, texting Chris to go ahead and feed the girls. I was starving and thirsty and grabbed some water from a disposable cup by the sink. The PA finally came in and said she was behind and started asking me questions that I was so over answering because OMG I was so done with being there so much that week already.
Finally, at 5:30 I had to wait for the lab to come and draw my blood for preeclampsia labs. I was then told….the results wouldn’t be back until early next week since it was after the 5:15 cut-off. Which, first probably would have been a good idea to draw them prior to everything else so they would be sent off on time, and second, I brought up to her, “Why are we even drawing labs for preeclampsia when I won’t even get the results for four days? If it’s preeclampsia, it’s important to know that ASAP, right?”
She paused and was like, “Oh yeah, you’re right.” She then said she could see about sending them stat so hopefully, I would get the results the next day, but I’m honestly not holding my breath that will happen. It was probably all very pointless.
Luckily, I don’t have anymore late afternoon doctor appointments, so it shouldn’t be the chaos it was today, but still. It does get really mentally and physically draining toward the end as these OB visits always inevitably change to twice a week for a solid hour and a half each. But the end is in sight. Hopefully I still have a few more weeks, but we’re getting to the finale.
