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So this is where all my creative energies have been going for the past three months or so

Friday, 30 August, 2013

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After doing so well with my once-a-week updates, this blog kind of ground to a halt. So sorry. As you probably gathered, something was up. I'm not sure if you realised what exactly, but I'm sure that those of you who have been waiting with baited breath to see if we would produce a sibling for Astrid have been expecting this.

So yes: I'm pregnant. I'm just on 14 weeks. The baby's due in early March 2014.

It was interesting going back and rereading what I had written when I announced my pregnancy with Astrid—what I had chosen to talk about and what I hadn't. This time, of course, it's all different. Here's a few things you might be interested in:

First trimester

All-day sickness (a.k.a. morning sickness) was just as ordinary and boring the second time around as the first. Fortunately I haven't had any stressful episodes, so things have continued to be vomit-free (yay!) Once again, I struggled with the constantly eating thing because I'm naturally lazy and want to eat on my own timetable, not my body's.

All-day sickness and pregnancy hormones made doing creative work near impossible. I couldn't concentrate. I had no motivation. I don't know how I managed to get any actual work done last time. I probably just pushed myself to do it. (It also helped that Christmas/New Year/annual leave got thrown into the middle of it.) This time, I think my nesting instincts started taking over: I ordered a mattress and a bed for Astrid (and got the mattress delivered, but I was going to pick up the bed because it was only in the next suburb, but then they said that it was at their new warehouse half an hour away, so I spent an afternoon going out there to get it, then arranged for grandparents to babysit while Ben and I put the bed together, and then it broke half an hour after we'd put it together by Ben just sitting on it, so we spent about two weeks going back and forth on the phone with the furniture company, demanding a refund [because if the bed rail was going to break like a twig at the slightest provocation, I did not want my daughter sleeping on it and so I did not want replacement parts, just a refund], but they refused until we started legal action against them in small claims court and reported them to the ACCC, and then when we told them, they sweetly agreed to give us a refund, provided we returned the broken bed, so I spent another afternoon driving out to their warehouse to return it); I finally sorted out her clothes (removed all the size 1 stuff and boxed it, as well as all the size 2 summer stuff, and made room in the wardrobe to hang her dresses); we finally bought a new chest of drawers to replace the ones we had inherited from Ben's grandma that were falling apart and that shed all over our clothes; and I tried to sort through some of the clutter and mess in our place (booking council clean-ups for our old foam mattresses and the old bunk bed that my brother and I used when growing up and had been intending to use for Astrid—only I discovered that they weren't standard singles so getting a non-foam mattress would have been impossible) and managed to deal with some of it, but there's still a lot left to do.

I tried hard not to beat myself up about being unproductive; after all, I was being very productive, creatively—well, procreatively speaking. It was good to be reassured about that when I met Clare Bowditch at the Big Hearted Business Sydney Morning Tea: she totally got it and reassured me that the clouds would part at the end of the first trimester, and to just go easy on myself for the next couple of weeks.

Apps

The What to Expect is quite helpful in tracking where the baby's up to (and what size of fruit it is) and what week I'm in. (I always forget.) I wish I'd had that the first time around.

What to expect app screen.

Medical things

I've decided not to use an OBGYN this time and am just seeing a GP until the Birth Centre takes over my appointments and I start seeing a midwife.

Unfortunately symphysis pubis dysfunction (SPD) (or pelvic girdle pain [PGP], as I most commonly refer to it as “pubis” sounds rude) has already kicked in with a vengeance. It started in the middle of Week 12, which I found hard because I had been hoping I would have a few more weeks. But apparently the body starts secreting the relaxin hormone at 10 weeks, and because I'm Asian (and therefore hypermobile—that is, loose joints) and because I've had it before, it was to be expected. So I've already been to the physio twice to re-learn all my exercises (and Ben had to re-learn the ones he has to do on me) and I'm already back to wearing the belt (which makes a MASSIVE difference). It looks like this:

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It's basically a thick strip of elastic with velcro bits (“strongest velcro known to man”, I think I wrote last time). I've already changed the way I move in just day-to-day things—walking with small steps (and waddling a bit like a penguin), taking stairs one step at a time, making sure I get in and out of the car and in and out of bed in a particular way, trying not to sit for too long, and so on. I feel a bit like Sophie in Howl's Moving Castle—suddenly a 90-year-old with limited mobility and joints that click instead of a young woman. (Maybe it's too much of an exaggeration to say that.) Anyway, pregnancy for me is most definitely not fun! I also wasted no time in getting a Mobility Parking Scheme pass, so now I am officially “disabled”.

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(That one only lasts for six months and expires a week or so before the baby is born. I'll probably be able to renew it, I think.) Since PGP is a major issue during my pregnancies and is highly likely to recur, I think this will be our last child (sorry grandparents!)

Ante-natal testing

We've already done the seven-week ultrasound and the nuchal translucency. The latter is when they do an ultrasound to check the thickness of the fluid in the baby's neck and to see whether or not the baby has a nasal bone. They also test the mother's blood to check the hormone levels. All of this is to determine the probability of chromosomal abnormalities—for example, if the baby has three of certain chromosomes rather than two (e.g. if the baby has three of chromosome 21, the baby probably has Down Syndrome). When I went in for the nuchal ultrasound, the doctor told me that the baby's neck looked fine and that there was definitely a nasal bone. However, several days afterwards when my blood test came back, he rang and said that my hormone levels were off—thus giving me a 1 in 24 chance of having a Downs baby. He urged me to have further testing. There were three options—two invasive and covered by Medicare, and one not invasive but not covered by Medicare (and therefore was very expensive).

That happened on Monday and Monday ended up being quite a ridiculous day: I got the phone call just before play group, and because I was upset, I drove my car into the kerb and flattened one of the front tyres, which I discovered later when I got in the car again to take Astrid to childcare. I thought, “Stuff it, I'll deal with it later” because I also had to be at the physio with Ben at 12. So I got him to pick me up at childcare, I left the car there, we both went to my physio appointment (when the physio showed Ben how to do the muscle massage on certain bits of me to relieve the pain from PGP) and then we both went to my GP appointment who now had the results of my nuchal ultrasound and blood test. (My GP also recommended further invasive testing to find out for sure whether or not the baby had Downs.) After that, Ben dropped me back at the childcare centre, I called the NRMA to fix my flat tyre, then went and bought two new tyres (because the guy at the tyre place recommended I replace one of the other back ones too), then ran a few more errands (including getting my disabled parking pass) before picking up Astrid and finally heading home.

In the 24 hours between initially receiving the news and thinking about my options, I completely changed my mind about invasive testing. At first, I was wary, having read Defiant Birth (edited by Melinda Tankard Reist) and how a lot of the women were pressured into invasive testing unnecessarily. For me, I didn't feel like a confirmation of Down Syndrome would change anything: I would probably still go ahead with the pregnancy. People did tell me that it was good to be forewarned, though, if that did turn out to be the case. Both the hospital doctor and my GP were recommending CVS (Chorionic Villus Sampling), which is when they biopsy the placenta. My GP said that doing the procedure carried a risk of miscarriage of 1 in 200—i.e. 0.5 per cent. Amniocentesis (that's when they biopsy the amniotic fluid in the uterus) carries about the same risk.

But fortunately for me, Emily Oster's new book Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong—and What You Really Need to Know had just come out at the beginning of the month. I heard about it because she started a pregnancy blog for Slate and then a few people sent me this profile piece in The Guardian. Oster is an Associate Professor of Economics, not a doctor, and the reason she wrote the book was because, when she was pregnant, she became frustrated with the advice she was receiving from medical professionals. Some of it was vague, some of it was contradictory and some of it contained blanket recommendations with no leeway for discussion. In the opening chapter of her book, she claimed she often felt infantilised in the way she was being treated, and that she decided to put her training as an economist to work in looking at the available data for any given issue (which often meant examining all the scientific research), weighing up the pluses and minuses personally, and then making a decision. I downloaded her book for Kindle on Monday night and skipped straight to the chapter on ante-natal testing, which was quite enlightening. The things I found helpful included the following:

The doctors were very keen for me to get tested as soon as possible. CVS can only be done towards the end of the first trimester, and provided the results of that are fine (i.e. no failure in the lab to cultivate cells, no mosaicism), amniocentesis is not necessary. (Amniocentesis is usually performed later in the pregnancy.) So the following day (Tuesday), I rang up and made an appointment to do CVS.

That happened today (Thursday). The above ultrasound picture is from the ultrasound they did, but the photo was taken on my phone, so sorry about the quality. The doctor checked the placement of the placenta with the ultrasound and it was on the front of me, which made things easier. Then they administered a local anaesthetic, and then they inserted a rather long needle that I did not look at. (I'm pretty good with needles, but I don't like looking at them going into me.) They used that to extract the sample. Then they removed the needle, got me to apply pressure to the area, checked the sample to make sure they had obtained enough (because if they hadn't, they would have stuck a needle into me again, but fortunately they had), and then they did another ultrasound and checked the baby's heartbeat (it was fine). Then they put a bandaid on the place where the needle had been and it was all over: I was told to sit up slowly, then stand up, I finally got to go to the loo (because they usually want you to have a full bladder when you have an ultrasound), and then a midwife talked through what would happen next: I'd get the initial results (meaning a definitive answer as to whether or not the baby had Downs, as well as whether the baby is a boy or a girl), then a couple of weeks later, I'd get the full results (after they had grown lab cultures and analysed them).

So at the moment, we're waiting. We'll find out Monday or Tuesday for sure.

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