Eternal Sunshine of Mel: July 2010

Introducing...

Aria Jiayi Liu

Born July 11, 2010 at 2:51pm

5 lbs 12 ozs

18 inches

*****

I haven't blogged about the pregnancy much since I didn't want to *jinx* it at the time. The first one, albeit with it's share of complications (low-lying placenta that moved at last moment, GDM, mild anemia, low AFI at the end) was a great experience. I felt good during the entire pregnancy (except for the occasional worries whenever the doctor mentioned something new going on), exercised the entire way through (kayaked 'til 6-7 months, swimming/stationary biking/walking to the end), and although Sierra was induced at 37.5 weeks, the experience was surreal, but not terrible.

This pregnancy was a challenge compared to the first. Mainly due to diagnosis of a short cervix at 19 weeks which essentially confined me to modified bedrest for the remainder of the pregnancy. It was a psychological challenge, because the doctors warned me that preterm labor could occur, and I spent the entire pregnancy worried the baby was going to be extremely premature, concerned about "viability" (ugh, hate that word) and developmental delays/anomalies, and that the baby would be in NICU for the first several weeks/months of her life. I had a cerclage placed at 22.5 weeks which involved an overnight hospital stay, with the procedure the following day (scheduled at noon, but did not happen until 2:30pm - difficult since I wasn't allowed to eat past midnight, yet my nausea was bad when I was hungry!). Spinal anesthesia - NOT FUN, did not enjoy the experience of getting it done (even though the anesthesiologist himself was great). But it worked and the procedure was painless, thank goodness. Waiting several hours to get sensation back in my legs was a drag. Didn't get home until early evening.... Cerclage was removed at 37 weeks sans anesthesia. Wow, talk about a test of my endurance of pain (doc and nurse agreed I have high tolerance for pain). However, it was worth it since I was in and out in 30 minutes. Hanging around for spinal block and then for it to wear off again was NOT an option.

In addition to the short cervix (which by the way stumped all the physicians as I had no history of cervical issues -i.e. incompetent cervix- and had a normal pregnancy before), I was diagnosed with IUGR (intrauterine growth restriction) at 32 weeks (baby was measuring small throughout the pregnancy 10-15%, IUGR is official when baby drops below 10th percentile). There was fear of premature induction if the baby's growth plateau'd. In contrast, Sierra was born a small baby, but measured normal throughout the pregnancy (30-60th percentiles). Doctors were not overly concerned as they believed we just make small babies. In most cases, IUGR is caused by an inefficient placenta.

I also had GDM (gestational diabetes mellitus) this time around. Instead of just the last trimester, I measured my own sugar levels and diagnosed myself to have it the entire pregnancy. 6+ months of GDM diet is much more difficult to maintain than 3 or less months. Note: GDM is caused by placental hormones.

Interestingly enough, I had GDM and IUGR. Oxymoronic, no?

But everything can be caused by the placenta. That organ just likes to challenge my mental psyche!

Let's see, what else... I had a low-lying placenta that moved. So we weren't crazy worried. Amniotic fluid levels (AFI = amniotic fluid index) were good for the most part, but was starting to decrease in the last few weeks (37 and on, AFI was dropping to 7-8).

In the end, I was induced at 39 weeks. After months and months of concern of premature labor, I never felt contractions and was induced. HA! Part of the reason we didn't wait until 40 weeks or to see if it would occur naturally is that there were signs the placenta was wearing down (my GDM was getting better, AFI was decreasing - which is normal, and a sign that placenta was not functioning as well as before). If the placenta is not working efficiently, the fetus is not getting as much nutrition. Since the fetus was small to begin with, it would be a good idea to get her out sooner... However, we did not want to induce earlier since GDM babies usually have lungs that mature later than non-GDM babies (37 weeks is fine for most babies, GDM babies - they like to wait until 39 weeks). Also, if the baby is TOO small at birth (less than 5 pounds), she'll automatically go to NICU.

Overall, I had over 20 ultrasounds by the end of my pregnancy. Perinatology clinic knew me by face and name - scary! Sonographers, nurses and OB all recognized me in hallways. That says something, huh?

A common question I would get (since we now have 2 girls) is whether or not we're thinking of having a third, and the answer is NO WAY! This pregnancy tested my limits of optimism and sanity. I am DONE!

Besides, for me, the perfect number is 2. As long as at least one of our girls (preferably both) can share in our love for outdoors and active lifestyle, then there is no need for a boy. Heck, even if we had a boy, what if he was a couch potato obsessed with computer games???

*****

So I was induced at 39 weeks. The experience overall was faster, pitocin worked twice as fast (started at 8am, delivered almost at 3pm... with Sierra, it was after 9pm with similar start time), and labor was much faster (last time, from start of push to delivery was ~30 minutes, this time was probably 10 minutes?). The only negative was the epidural. I was VERY nauseous with the anesthesia this time. I think they gave me larger boluses. Also, the anesthesiologist was in a rush this time, and I believe did not put as much care into his work as my previous experiences/anesthesiologists. Overall, I was happy with everything except HIM. Hm, he may get a nasty review from me if I get a survey to fill out. But L&D nurses are awesome at Scripps Memorial. Always very competent, and technically very good. I had my own OB deliver Aria which was a boon to scheduling your own induction. :)

We stayed in the hospital overnight and was allowed to leave the next afternoon. Dave brought Sierra to meet Aria and we all left together as a family!

A few pictures:

7am checking in at the hospital