Checkup

We saw Dr. Kuppens today at the hospital. The transvaginal ultrasound showed my cervix is 3.2 cm long, down 1.4 cm from Feb 4 but still not a cause for concern. If it starts heading for 2 cm (1.5 cm is the 'start thinking labor' point) then they'll admit me, give me steroid shots for the baby's lungs (which need 48 hours to work), and operate. From now on I'll be going in twice a week for cervical checks.

Dr. Kuppens also took a quick look at the baby via abdominal ultrasound. Everything looks fine and we heard a solid, steady heartbeat. He's certainly been kicking and pushing around in there enough lately to keep me from worrying about him.

My pee, collected at home this morning, was lovely, no protein or sugar or anything else off kilter. In a charmingly ecological departure from US protocols, the nurse rinsed out my sturdy, lidded plastic pee cup and gave it back to me to use for next time.

I weighed in at 64.5 kg (142 lbs), down 0.2 kg (almost half a pound) from two weeks ago. In total I'm up 7.5 kg (17 lbs) this pregnancy.

On an ironic but positive note, I don't have gestational diabetes this time. (I've been checking my blood sugar at home regularly since 20 weeks.) In fact, everything else about this pregnancy is perfect: blood pressure, blood sugar, weight gain, how I'm feeling. Textbook. If it weren't for that technician at the 20-week ultrasound, we'd be blissfully heading for catastrophe. Intervention-wary though I am, I'm now an ardent supporter of the 20-week ultrasound.

I asked about having my tubes tied as long as they're in the area, and Dr. Kuppens said it was less than two minutes' extra work, but perhaps it's better not to do it right away in case something goes wrong with the baby. My husband is also reluctant for me to do it.

Right now I feel like this decision doesn't hinge on what happens with the baby; we didn't plan this pregnancy, I'm 40, and we've been looking for a permanent birth control solution for a while. I've probably got another 10 fertile years to go. Since condoms clearly aren't foolproof, we need something else. This pregnancy was enough of a shock; I won't be happy at all if it happens again at, say, 45. But I concede that I might feel differently if things go wrong now.

It's not an operation I'd have on its own, so if we don't do it during the c-section, then we'll have to find some other solution. Vasectomy is on the table, but understandably not very appealing to my husband. We'll see.

After speaking with Dr. Kuppens, we headed up to the maternity ward on the 12th floor. We wanted to see if they are indeed prepared for us if we call suddenly and need a rush c-section. They weren't, but now they will be: Dr. Dietz (the obstetrician who explained exactly what we were dealing with two weeks ago at the 30-week ultrasound) will hang up a sign with my name, birthdate, patient number and staff instructions for if we call. She'll also send an e-mail to every nurse on staff so all are aware.

It was a frustrating 45 minutes, and I cried through about ten of them, but I'm glad we did it. The last thing we need is a nurse who answers the phone and thinks, "Yeah, right, you say we need to call in an OR team, but I think I'll just see what the doctor has to say about that." Not that this is an unreasonable response--we completely understand it. And we understand a nurse who thinks, "Poor dear, this must be her first, she's so panicked" and waits ten minutes for the doctor to finish checking someone's dilation before she informs him. But we can't afford any misinterpretations of our situation. We can't afford for someone to wait for my file to be brought up from the second floor before calling in the OR team*.

With every visit we get closer to making conditions ideal in an emergency. With luck, we won't have to find out just how well we've done.


* unbelievably enough, Catharina Hospital still works exclusively with paper files; no electronic patient records.