Thursday afternoon, I had an ultrasound appointment. The goal was to ensure that the frequent contractions I'm having (some days, 5 or 6; others, over 20) aren't doing an overly good job of preparing my body for labor. Although the frequent contractions themselves weren't concerning to my midwife, she suggested I have an ultrasound to measure my cervical length and be sure that the contractions aren't thinning my cervix. The cervix should ideally measure between 35-40 millimeters in the second trimester, and a shorter cervix can have a direct relationship to risk of preterm labor. At my 20 week ultrasound, my cervix was a nice, safe 37 mm.
At my appointment on Thursday, the doctor measured my cervical length to be between 25 and 30 mm. The doctor who performed the ultrasound said that that is thinner than average and we should "keep an eye on" me going forward. The good news, though, is that Baby Girl is growing nicely and looks excellent. She weighs 2 pounds 8 ounces, which I know is at least slightly more than average for her age, and she's still moving around like crazy (she's kicking so hard right now that it's moving my laptop on my lap!).
I've had other changes going on recently in the area of prenatal care. My first midwife, Jennifer, is excellent and I've been extremely pleased with her. I took a risk in seeing her, though, because she does not currently have an agreement to deliver her clients at any hospital. Prior to last year, she was delivering about half of her clients at home and half at Lincoln Park Hospital. When Lincoln Park Hospital closed, she had a temporary agreement at Swedish Covenant, but since that expired she's been trying to reach an agreement with another hospital. Jennifer felt confident that she would be approved to deliver at Rush by November, which would have been perfect for us since it's so close to home. When she wasn't approved at Rush earlier this summer, she suggested I look for a new service provider since I want to give birth in a hospital. That was really disappointing news, obviously. I really liked seeing Jennifer and especially the fact that she was the only midwife in her practice- I was the only Emily in her cell phone and knew that she would be with me at my birth.
West Suburban Midwife Associates is the other midwife group I considered before going with Jennifer. There are 3 midwives in the group- more than Jennifer, but fewer providers in the delivery rotation than a standard ob/gyn practice. They deliver at West Suburban Hospital in Oak Park, which is further from my house but has an Alternative Birthing Center within the hospital with birthing tubs and furniture (even a microwave and refrigerator) much like a home. I called them earlier this month and had trouble scheduling an appointment, likely because I was trying to schedule my first with them at about 24 weeks- not the ideal client. As soon as I spoke with the owner and mentioned that I was transferring care from Jennifer, she scheduled me an appointment as a new client.
My appointment with West Suburban Midwives was on Thursday after my ultrasound appointment, which was convenient because I has so many questions regarding the ultrasound. The midwife I saw, Amy, was really great. She took a lot of time to answer my questions about the practice and then answer all my questions about the ultrasound. Amy suggested I come back Tuesday for a fetal fibronectin test (fFn test). If the results are negative, there is little chance that I'll go into labor in the next two weeks and we'll continue to do an fFn test every two weeks until I deliver. The fFn tests have a high false positive rate, though, so there will be more to discuss if the results are positive, and we didn't really cover any of that yet. We're just hoping for a negative result. Amy also said that in general, I need to avoid any lifting, avoid using my abdominal muscles as much as possible (not easy given my job), and start thinking about making myself available to go on bedrest. We talked, too, about where I would deliver depending on when I go into labor. If it's prior to 35 weeks, I'll go to a bigger hospital for their Neonatal Intensive Care Unit (either Rush or Northwestern). If it's 35-37 weeks, I can deliver with one of the midwives at West Suburban but I won't be able to use one of the rooms in the Alternative Birthing Center. If I go into labor after 37 weeks, I can give birth in the Alternative Birthing Center, which would be ideal.
For now, I'm grateful that Baby Girl is healthy and growing and that we have technology available to hopefully help us in preventing a premature birth as much as possible. We tell our little one every day to stay inside until November. I'm thankful for every day we're given with her still safe and healthy inside, and I'm praying that she'll make it long enough to be strong and healthy and hopefully avoid the NICU. Plenty of babies are born at this age, but still, every day is important in her development. We'll see how Tuesday goes and take it from there.