Because it was unclear to us that the middle of a global pandemic was really such a great reason to avoid having another baby, we did what married people do, and then blushed our way through pregnancy announcements last May. IMPECCABLE TIMING. Life will find a way, you know?
As with past pregnancies, I had some crazy overnight highs right around implantation time. My typical problem, pregnant or unpregnant, is overnight lows. But I woke up two or three days in a row in the 300s. Crazy! I didn't think much of it at the time, but then my husband said I looked pregnant. (It is absolutely weird when your husband suspects you are pregnant before you do, especially when you know well what pregnancy is like because you’ve done it six times.) Then I started falling asleep right after dinner. Then, I took a pregnancy test, looked back at my NFP chart to determine the date of ovulation, and figured we were due for some intense pain right about mid-January.
So I began my seventh pregnancy, this time with Hashimoto's and celiac and some other intestinal strangeness. I did not experiment with a fancy diet on myself, and will not promote a fancy diet to you, as the best suggestions I've heard seem to involve eating little more than roots and raw meat, and definitely nothing that could raise my blood sugar if I happen to give half a unit too much insulin. That’s not a great thing for pregnancy.
One thing I did, as with last pregnancy, is to just be a bit more relaxed. This worked well last time. I already know how to keep meals under 50 carbs. I know how to say no to extra sweets. I know that I need to get up and check my blood sugar in the middle of the night. I know that an A1C of 6.5 is OK, and that my baby isn’t going to die if my blood sugar goes over 300 once a month. I know that I don’t need to panic if my two hour postprandial is above 140. I know all these things, now I just need to practice. I gained more weight than in previous pregnancies — 50 pounds rather than 40 — and that always causes some anxiety. I’m hoping it comes off like before.
Another thing I decided to do was go back to strips rather than a continuous glucose monitor. In the first place, Dexcom treated me badly last time I tried to get supplies from them. I was so annoyed that I stopped using the monitor. But I decided not to go back on it, even during pregnancy, because the CGM made me paranoid. I was constantly watching it and getting anxious. I spent too much time trying to tweak my doses, rather than doing my best and trusting that everything would be OK. The CGM works off interstitial fluid rather than blood, and that means my blood sugar looks high for a really long time, even when it's not. The anxiety caused by that really messed me up.
As with past pregnancies, I had some crazy overnight highs right around implantation time. My typical problem, pregnant or unpregnant, is overnight lows. But I woke up two or three days in a row in the 300s. Crazy! I didn't think much of it at the time, but then my husband said I looked pregnant. (It is absolutely weird when your husband suspects you are pregnant before you do, especially when you know well what pregnancy is like because you’ve done it six times.) Then I started falling asleep right after dinner. Then, I took a pregnancy test, looked back at my NFP chart to determine the date of ovulation, and figured we were due for some intense pain right about mid-January.
So I began my seventh pregnancy, this time with Hashimoto's and celiac and some other intestinal strangeness. I did not experiment with a fancy diet on myself, and will not promote a fancy diet to you, as the best suggestions I've heard seem to involve eating little more than roots and raw meat, and definitely nothing that could raise my blood sugar if I happen to give half a unit too much insulin. That’s not a great thing for pregnancy.
One thing I did, as with last pregnancy, is to just be a bit more relaxed. This worked well last time. I already know how to keep meals under 50 carbs. I know how to say no to extra sweets. I know that I need to get up and check my blood sugar in the middle of the night. I know that an A1C of 6.5 is OK, and that my baby isn’t going to die if my blood sugar goes over 300 once a month. I know that I don’t need to panic if my two hour postprandial is above 140. I know all these things, now I just need to practice. I gained more weight than in previous pregnancies — 50 pounds rather than 40 — and that always causes some anxiety. I’m hoping it comes off like before.
Another thing I decided to do was go back to strips rather than a continuous glucose monitor. In the first place, Dexcom treated me badly last time I tried to get supplies from them. I was so annoyed that I stopped using the monitor. But I decided not to go back on it, even during pregnancy, because the CGM made me paranoid. I was constantly watching it and getting anxious. I spent too much time trying to tweak my doses, rather than doing my best and trusting that everything would be OK. The CGM works off interstitial fluid rather than blood, and that means my blood sugar looks high for a really long time, even when it's not. The anxiety caused by that really messed me up.
I called my endocrinologist early on, and she prescribed levothyroxine. This was a hassle because she actually prescribed Synthroid, and insurance wouldn’t pay for Synthroid without paperwork that my endocrinologist wouldn’t fill out. (And insurance wouldn’t let me fill it out, either...ugggggh). It was kind of an emergency to get on the meds. My endocrinologist was worried about a miscarriage because of the thyroid stuff. I couldn’t really wait for the two week process that insurance required to get them. So I went on the generic levo.
One thing that was GREAT this pregnancy was being able to do telehealth visits with my endocrinologist. I still needed to have the blood drawn in person, but if you’ll remember, I once had a doctor fire me because I wouldn’t come to the office for appointments, and I couldn’t come to the office for appointments because I couldn’t find a babysitter. (I also didn’t think I needed to put down the $$$ for them, and that doctor didn’t accept my insurance.) The babysitter and insurance problems remain, but now, I can have a video call with kids crawling all over me yet not breaking any medical equipment. One of the worst parts of pregnancy for me in the past has been the ridiculous number of doctor’s appointments they want me to come to. Telehealth made that easier.
I felt movement from baby early again, and that was reassuring. I did not visit the OB until about 16 weeks. I did do the early fetal screening for abnormalities, but after a rather tortured phone call with my OB where I had to ask whether this information was going to help me make my baby healthier or help me decide whether we should kill it, I sort of regretted doing the screen. I guess the fact that I’m now having an old lady pregnancy — advanced maternal age and all that — got me kind of spooked. But as I’ve said before, I will know based on the copious number of ultrasounds that they do if there is really something wrong, and I will know well before birth. I don’t need to find out at 12 weeks.
I felt movement from baby early again, and that was reassuring. I did not visit the OB until about 16 weeks. I did do the early fetal screening for abnormalities, but after a rather tortured phone call with my OB where I had to ask whether this information was going to help me make my baby healthier or help me decide whether we should kill it, I sort of regretted doing the screen. I guess the fact that I’m now having an old lady pregnancy — advanced maternal age and all that — got me kind of spooked. But as I’ve said before, I will know based on the copious number of ultrasounds that they do if there is really something wrong, and I will know well before birth. I don’t need to find out at 12 weeks.
My 20 week ultrasound was normal, in an anatomical sense, but the baby was on the small side. This was OK, and I basically just felt less stressed about 191 mg/dl than I would have in other pregnancies. My thyroid numbers stayed good, dosage adjusted slightly. Baby kept moving. A1Cs dropped from 6.2 (I think) at the beginning of pregnancy to 5.7 (I think) closer to the end of pregnancy. Early on, I cut dairy out for a couple months to see if it would help with the pain I have in my belly, but it did nothing. Boy, was I glad eliminating dairy didn’t make a difference to my pain level, because have I mentioned that I love a little coffee with my milk in the morning?
At some point in the third trimester, baby’s growth looked to be worse. He had dropped from thirtieth to eighteenth percentile. In early December, the fluid levels were low. Doctor and I both immediately worried about intrauterine growth restriction and/or placental insufficiency, but decided that drinking water and waiting for one more ultrasound was advisable before doing anything crazy.
It was extremely strange to have a baby too small. With a baby too big, I always felt like I could control that. I could eat less, eat different things, watch blood sugars like a hawk. Every day, there would be dozens of decisions I could make that would help keep my big baby’s size closer to normal. But with a small baby, there is apparently nothing you can do. You can’t make the placenta work better than it is once it’s not working well. There is nothing special you can eat, no meds you can take. It was frustrating, but also freeing. All I had to do was eat normally, drink water, and rest.
One thing I did do was drill my doctor on how to do fetal kick counts properly. If we were dealing with placental insufficiency, I wanted to be sure I was watching for things to go south for the baby. When do I call? How many is enough? And his advice was good. He said to lie down after eating without any distractions, and count until I got to five movements. As soon as I got to five movements, I could get up. This was a real time saver compared to how I’d been told to do kick counts before, and good for a busy mom. I don’t have to lie there for an hour and count all 36 movements my active baby makes. I just have to get to five movements in 30 minutes. If baby is taking a nap — they don’t nap longer than 30 minutes before birth — then I could go for ten movements in a full hour. This baby never made me wait that long, though. He always gave me the five movements I needed in ten minutes or less.
At the next biophysical profile, everything was fine. It was a nice Christmas gift. His percentiles were back up and fluid levels were normal. My movements got slower and slower, but he kept kick kick kicking. I kept doing kick counts, and he always passed with flying colors.
Towards the end of pregnancy, as always, I was hoping that I would go into labor early. But, as always, I didn’t. I got to 38 weeks and my doctor very sternly insisted that I needed an induction at 39 weeks, because of the diabetes and the thyroid and the celiac and the old age. I was disgruntled at his advice. I have never consented to an induction at 39 weeks and always want to go to 40. I don’t know why... something about feeling that labor will go better for my tired uterus if I just give it an extra few days of warm up... like I will do better if my body gets to decide when we start... induction feels like a forced march rather than a leisurely stroll... and in general, what’s better for mama is better for baby.
Of course, I’ve always said that if baby is in trouble, cut me open and get him out. I’m not going to quibble with that. But I get tested and poked and prodded all the way through pregnancy. I want my doctors to prove to me there’s a problem, not just say that there might be. I’ve been a happy nine-month home for seven babies now, and I resent being told that my baby is about to die just because I suddenly got to day 273. I resent this largely because I’ve been told by doctors that my body will never be a good home for babies, at any time, and they were wrong. Don’t rush me, don’t tell me I’m not good enough for my baby, and prove there’s a problem before assuming there is one.
So I pulled a fast one and talked to a different OB in the practice and asked her if it was OK to wait just one more week. I explained to her about wanting to give my body time, my previous pregnancy experiences. She thought waiting until 40 weeks was an acceptable course of action.
Of course, having taken this risk, I now felt even more responsible for my baby’s life. This is kind of weird, because I’d been 100% responsible from the beginning, and knew that I’d be 100% responsible when I brought him home from the hospital, too. And of course, I would grieve like he was 100% my responsibility if he died. Yet there was a heightened awareness that if he died during this week, I’d have turned down a delivery that might have saved him. I knew that I was asking for more time for my body, and they were telling me this might be a risk to my baby’s body. I didn’t want anything bad to happen to him, but I also didn’t want anything bad to happen to me. I didn’t want anything bad to happen to him, of course, but I also suspected it would be fine like it was in the past. I’d been told that the worst would happen so many times in the past and it hadn’t, so my history had led me to believe that everything would be fine despite dire predictions to the contrary.
Ready for the birth story? Buckle up. Spoiler alert: IT WAS NOT FINE.