Welcoming Audrey: A High-Risk Pregnancy.
Getting pregnant with Audrey took some time, but we were so happy to finally be expecting a second little girl to our family. Once we shared the happy news with our families, we began putting in the “hard work” on a high risk pregnancy.
After delivering Julia, at 29 weeks 1 day, we knew that our next pregnancy would be filled with more appointments and monitoring. But we were in the perfect place to be cared for. Our healthcare team was phenomenal, and I was so happy to see them for a second time around. Because a lot of the reasons why I delivered Julia were still unknown at the time of my pregnancy with Audrey, we began a routine that may be unnerving to some, but was oddly calming to me. We began biweekly cervical length scans, as well as weekly progesterone shots.
A high risk pregnancy, is an emotional roller coaster. Well, for me it was. After dealing with a hospital bedrest and then a subsequent long NNICU stay with my first pregnancy, and then some postpartum depression sprinkled in I knew that I had to get to a place and get people in place to make me feel I was on the best path for a successful pregnancy this go around. Having a medical practice that is supporting on a medical, emotional, and physical level was so important for us. My hands down absolute favorite OB was key to this, along with several of the nurses, and even a few familiar faces of nurses that walked the journey with us during Julia’s birth and NNICU stay. My husband and a few close friends were also extremely important to me during this time, I was not at 100% emotionally and this group built me up and kept me sane. Even when I was a wreck and just wanted to sit and watch mindless hours of Steve Martin movies with a cup of hot chocolate, Dave was there for the ride. I cried just about each week that I wasn’t in the office on the phone with a nurse, named Sherri that was like a therapist to me, she was so kind and assured me that we would get to the finish line, she even helped me track down my favorite Doctors schedule to be able to get some appointments with him. Dr. Pettker is so down to earth, and nothing rattles him. He is the guy that you want to have in a pressure cooker situation: calm, cool, and collective. He was like okay, big deal- you’re okay and we would move on, efficiently making my anxiety seem valid but not a worry. He delivered Julia, and we met seconds before I was put under. I remembered his glasses and curly hair under his cap. From that moment on I did what I could to get an appointment with him when he was on the schedule. Having open lines of communication with my providers on how I was feeling physically and emotionally was so important to me. They knew the emotions that were surrounding my pregnancy with Audrey, because they cared for other women that had suffered from PPROM.
We developed a care plan that included attending a birthing class about C Sections so that I could learn more about my options and a birth plan, cervical length scans, genetic testing, as well as progesterone shots. We would also schedule my repeat cesarean for 36 weeks 4 days. Because of the emergency c-section that I had with my first delivery, I wasn’t able to carry much longer than that time window- 37 weeks was the cut off for us.
36 weeks!
I truthfully can not express how important it is to have a team in place that you can be yourself with. I came armed to just about every appointment with a post it note with questions, mostly because of the pregnancy brain that would make me forget when I got to the office. At the time of my first MFM appointment I was 12 weeks, and we were starting the paperwork to get insurance approval for my injections. Insurance paperwork can feel overwhelming but I did my best at getting the ball rolling before my appointment to see exactly what the insurance would need to approve the progesterone injections. It was really a time sensitive matter between the first appointment with the MFM Team and getting the injections approved and shipped in time for the first one at 16 weeks.
Progesterone shots. Let me just say this, those are not a walk in the park. I was the biggest baby with needles, and then I factored in that my husband with ZERO medical training would be giving me the shots, that was unnerving. He was trained by a nurse at my 16 week appointment and then faithfully every Tuesday morning at 9 am it was our routine. From 16 weeks until 36 weeks. We chose to do the shots at home after the first one because we didn’t want to have to drive to our Maternal Fetal Medicine office to have it done by a nurse, we were confident that we could handle it at home. Plus, the way that some of the weeks landed it happened to be on major holidays and the office was closed. Some shots were easier than others, but none the less we got the job done. We would alternate different upper butt cheek areas, and the right side always hurt because towards the middle to end of the pregnancy I had developed a bad sciatica pain that was just awful and I felt like the shot irritated it because of how I had to position myself. My husband, Dave, was a trooper because I was not pleasant. I always rewarded myself with a hot cup of coffee and a warm toasty bagel afterwards. Having something to look forward to after every injection made it a little more tolerable. I am also super thankful that we were fortunate enough to have incredible insurance coverage, because each months injections costed about $2250. After we met our deductible the injections were only a copay of $5.
Cervical Length Scans. Because it was still unknown as to why exactly my water broke at 27 weeks 4 days with Julia, we covered every base we could. A part of the care plan was to have scans done to see if cervical incompetency was playing a role in the pregnancy. Luckily, that did not seem to be the issue. I looked forward to every single ultrasound. We made sure to get the same technician every time, her name was Rachael. She was the best, she always took her time, and was so kind. She was extremely thorough and helped us get a little glimpse of our girl every time we saw her, she was so comforting it felt like catching up with an old friend. Until one appointment about three weeks before Christmas, when my cervix shortened, barely. I went into a panic and then was told to come back that following week for another scan to see if it had changed any more over the weekend. If my cervix did shorten we would discuss further medical intervention, and even hospital bedrest. I felt so off from our routine, because we had a different ultrasound tech, and the doctor that I had seen after the scan was one that I had with my first pregnancy. He knew I was so nervous and was there to reassure me, and to let me know that we had options if in fact I needed any intervention. Luckily on the return appointment that next week, and an emotional breakdown with my nurse on the phone we were back on the right path. It was a marginal discrepancy and I was calmed down to know that I wouldn’t be admitted into the hospital before Christmas. What a relief! I think I sprouted a dozen pure white hairs on my head that week.
After every MFM appointment, Dave and I would have a little coffee date at one of our favorite places. Those coffee dates at Maison Mathis turned into a date for us, and it was so nice to have that time together the two of us to reflect back on our appointment and chat about what was coming next. We did our best to talk about our anxieties and to celebrate the milestone we achieved by being another week pregnant. Being pregnant for the second time, I really did my best to enjoy every minute of it. I didn’t feel as exhausted or sick this time around and truthfully, I wish I could do it all over again sitting here 15 months later writing this.
During this time of our biweekly appointments, I really did my best to make sure that we were still doing stuff as a little unit of three before we turned into four. So grocery shopping turned into a little family affair on Saturday mornings and we went to breakfast almost every Sunday morning with Julia too. It was so nice to not have to cook and to just enjoy that time together, Julia is a big breakfast fan so she loved every ounce of it. Dave also started to take over more of her nightly routine too because I was too uncomfortable to give her a bath some nights. I think it was good for them too, it gave them some one on one time together to bond and it let me straighten up from the days madness. It also got her used to having him give her a bath so that when Audrey came it wasn’t another shake up in her routine.
We scheduled a birthing class, and I came prepared with so many questions on what would happen during the surgery, and if I was able to write a birth plan to express my wishes of what I wanted. I was so relieved when the instructor told me that I in fact could have a birth plan and as long as everything was going according to plan it should be an issue to have the team follow it. I immediately got to work on writing what my wishes were, so incase I was incapacitated at any point or didn’t remember they would be able to help execute my wishes. I also made sure to share this information with Dave too, so that if there was anything he had questions about we could discuss it.
The weeks really started to fly and then we started talking about scheduling my surgery. In January I started to hunt my OBs schedule down, I would use a different word but that wouldn’t be accurate. When I found out that he would be on schedule the week that I would be delivering it felt like fate. I also asked my labor nurse that was there when I delivered Julia to be present for Audreys birth too. She became such a special part in our family, because she was there to hear Julia cry for the first time. We did our best to really recreate the delivery room, minus the chaos, of Julia’s birth for Audreys since I was under general anesthesia (I was not awake for it) and Dave was also not able to be present in the OR. Even though every single birth is a different experience, we really wanted to room to be filled with as many familiar faces as possible. I, especially, wanted people that I felt knew me and how extremely monumental this moment was for me. I was so proud to actually make it into the hospital that morning, on my own terms! I will share more about Audreys birth in a later post.
Being pregnant and carrying a child is no small task, and truthfully probably some of the hardest work I have ever done. In this series of Welcoming Audrey, I am going to share more of our experience with our High Risk Pregnancy and our journey to bringing Audrey home. I hope that you enjoy this series, this is so personal to me, so I am happy to bring a little awareness to high risk pregnancy as well as just adding a new baby to the mix.
