It's been quite a while and I have neglected my blog, but now I plan to get back into things :)
Why suddenly start writing again?
I'm expecting baby #4!
Total surprise, we were avoiding but the universe had other plans.
I'm 15 weeks currently and it has been an incredibly stressful pregnancy so far.
When I was 7 weeks I told my gastroenterologist I was pregnant. I had a severe flare last year and had only been in remission (with a small amount of ulceration discovered in June literally days before I was meant to have conceived according to my ultrasound, that has been managed with an increase of my 6mp, I am symptom and inflammation free) as of December and wanted to know immediately how my treatment was going to change.
Fortunately for me, I can safely stay on my medication but the infusions will be stopped at 32 weeks so baby isn't as immune supressed as if I was to stop it later. Baby will still be immune supressed for 6 months so I will have to be extra cautious, as I am with myself.
You may be wondering, if I will be doing either the birth or the pregnancy unassisted again. The answer is no, not at this point in time, and definitely not the pregnancy, this is a time when I need a professional to anticipate and detect any abnormality.
This pregnancy is high risk due to my Crohn's disease.
With Crohn's disease your baby is at risk of low birth weight and premature birth. Also due to the type of medication I am on, I am at a significantly higher risk of infection.
While I have always been mildly flaring from the age of 17 and haven't had any issues (my daughter was lucky she was born at term and was just over the threshold for low birth weight, at the time we attributed that to my hyperemesis and struggle to gain weight, we now know my Crohn's was also a factor) after what we call a mega-flare, I have lost some faith in my body. I know my gut is scarred and may not absorb the nutrients necessary. I'm not taking any chances when things with my Crohn's has changed.
When I was 11 weeks I had the nuchal translucency ultrasound and related bloods because with 6mp defects can occur (there is not all that much research out there for me to say it's perfectly safe) but given how severe my Crohn's is, it is safer for me to be on medication than not. If I flare, I could lose my baby and my life. It's a fairly easy decision to make.
When I saw the OB he said the bloods (PAPP-A) level was a little low, not significant though but it means I will need another hormone test later on and monitor the growth of baby closely. Low PAPP-A levels can indicate a problem with the placenta function, but doesn't always indicate a problem at all, the placenta could just be a little on the smaller end of normal. I see the Dr. in a few weeks and I plan to get the specific numbers. Because I like to work with numbers. With autoimmune diseases a low PAPP-A level seems rather common, hence the risk of preterm birth and low birth weight, so I am very aware my baby may be small or born early.
I'm not 100% comfortable with the OB I met, the very first thing he mentioned to me after introduction was induction at 39 weeks after a cervical examination. For no other reason besides I give birth very quickly and might not make it to the hospital. I said I would not discuss induction until it became medically necessary but I'm sure it will be brought up again...
I will not hesitate to be induced if there is a problem with me or the baby/placenta, but I will not endure an induction and the risk of infection from people putting things in my vagina for the purposes of ensuring I'm in hospital when I give birth if everything is actually fine. Thankfully there are other OBs that work at the hospital I am getting my prenatal care at so I can get different opinions.
I have been assigned a one to one care midwife (group practice midwife), I have only spoken to her on the phone so I haven't made an opinion about her yet, I meet her in about a month. She does a lot of water births, so assuming I make it to term and don't decide last minute to stay home, I will be having a water birth.
I cannot safely have an unassisted pregnancy, as I said before, my baby will be monitored closely and have at least one growth ultrasound around 32 weeks. I am not sure at this point in time if I am comfortable with unassisted birth, it really depends on the health of my baby and myself. Crohn's does not stop me safely giving birth (or I would not have had R at home unassisted) but after last years flare, I'm not going to pretend things haven't changed.
I have been incredibly stressed because of the extra attention from the medical professionals I had not anticipated and the unexpected timing of the pregnancy itself, the most significant stress factor is the fear, the overwhelming fear that something could go wrong.
My estimated due date is the 15th of March, just a couple of weeks before my daughter's 6th birthday.
This probably way too long now so I will end this here. I'll share a belly pic progression next post and will write about the placenta encapsulation I did last year as promised, pictures included. I will also update more on D, J and R.
I am still nursing R, I am not weaning him unless I need to for medical reasons.
I look forward to sharing this journey, and if you have any questions I will answer as best as I can.
Namaste.
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