Small measures

I’ve been really lucky because my pregnancy, in general, has been very smooth. There was that cyst on baby girl’s brain but luckily that resolved itself and ended up not being an issue. Thankfully, the rest of my pregnancy has been almost textbook and I have not had anything to cause me much concern. But my most recent check-up was on December 16 and it started off badly and got me progressively more worried as the appointment went on.

I was already annoyed because my appointment was supposed to be early in the morning so I could go before work, but the doctor’s office called a few days before to let me know that the appointment had to be pushed back an hour and fifteen minutes because one of the doctors had to be out of the office so there was only one doctor available that morning. It was annoying because I was going to be late for work but, oh well, I’d still get to work before noon and it would be fine. When I got to the doctor’s office, the waiting room was pretty packed so I was thinking, oh man, this is not a good sign. I was right. By the time I actually entered the examination room, it was 40 minutes past my appointment time and I hadn't even seen the doctor yet. I was really annoyed and feeling anxious because I had things I needed to do at work. I tried to calm down but could feel myself getting more and more anxious as I waited.

Normally the first thing the nurse does when I show up for my appointment is check the baby’s heartbeat with a Doppler. When the nurse checked the baby’s heartbeat this time, it was a bit erratic. There were fast beats and then slow beats and then the beats would speed up again. It was kind of odd. The nurse got nervous and called in the doctor right away to take a listen. I was thinking, "of course the baby's heartbeat is going to be erratic because her mom is feeling pretty amped up right now!"

My doctor listened to the heartbeat and asked me some questions. “Has the baby been moving regularly?” Yes. “Have you had any cramps or bleeding?” No. “Has she been especially active this morning?” Yes. “Are you feeling okay today?” Other than the 40 minute wait in the waiting room? Yes. After that, she didn’t seem too terribly concerned. Since the baby was still moving as normal, she said that the Doppler sometimes doesn't pick up sound well and it could be because she’s moving a lot and the sound is not being consistent.  Since everything else seemed to be fine, she told me not to worry.  I thought, okay, she’s not freaked, I’m not going to freak. She’s the expert here.

Then the doctor went to measure my fundal height. Fundal height is the distance from the top of the uterus to the pubic bone measured in centimeters. As the baby grows so does your uterus. Fundal height is a pretty good indicator of how well a pregnancy is developing.

Fundal height of the uterus during pregnancy.

After the first 12 weeks of pregnancy, fundal height measurement often matches the number of weeks you've been pregnant. For example, if you're 27 weeks pregnant, your health care provider would expect your fundal height to be about 27 centimeters. It isn't unusual, however, to measure somewhat smaller or larger than expected. In other cases, fundal height that measures smaller or larger than expected — or increases more or less quickly than expected — could indicate a problem that is dangerous to the baby, such as:

• Slow fetal growth (intrauterine growth restriction)
• Rapid fetal growth (macrosomia)
• Too little amniotic fluid (oligohydramnios)
• Too much amniotic fluid (polyhydramnios)
• Uterine fibroids
• A baby prematurely descending into the pelvis or settling into a breech or other unusual position

Sometimes a small or large fundal height can be caused by something as simple as a mother who

• Has a tall or slim frame
• Has a short or heavy frame
• Has a full bladder
• Is carrying twins or other multiples

Up until this point, my fundal height had been pretty spot on. But this time when the doctor measured me, she said I was smaller than expected. I was 35 weeks pregnant but measuring at about 32 weeks pregnant. I hadn’t gained that much weight and since I was measuring small, the doctor decided she was not terribly worried but still wanted to “check on things.” Since fundal height only gives you part of the story of baby’s size, she ordered me an ultrasound for a few days later. The ultrasound would be able to more accurately measure baby’s size and development to make sure that she is growing well and rule out anything else causing me to measure small.

After we discussed the height, the doctor decided to check my cervix just to see if anything else was going on.  As she checked she said, “Yup, you’re a little dilated.” Oy vey! So, immediately I panicked and thought, “it is too early – I'm not ready!” My doctor reassured me that everything was fine and that in first pregnancies it’s not uncommon to start dilating weeks before you actually go into labor. I have been getting more contractions in the past few weeks and can already feel the baby slowly starting to lower (mostly because I run to the bathroom a billion times a day and feel like there’s a bowling ball sitting on top of my who-ha). And without being too vulgar, I’ve been, umm, going #2 a lot and having back pain often. Apparently all this is very normal. It’s just the ‘ole body gearing up for the big day!

So I went for my follow up ultrasound last week. This was the fifth ultrasound I’ve had since I’ve been pregnant, which is just crazy. Most people do not get to see their baby this often. Obviously I enjoy seeing her, but dang! The timing was right and, since my parents were in town for Christmas, my mom and sister were both able to come with Brian and me to the ultrasound.

I had the same ultrasound technician this time that I had at my last appointment when we were checking up on the cyst. She kind of looked at me like, "why are you here?" since everything was fine the last ultrasound I had. She measured everything during the ultrasound and said I looked great. The baby was measuring perfectly and her heartbeat was nice and steady at about 130 beats per minute. She's much bigger than the last ultrasound and it was so awesome to see how much she's grown. My amniotic fluid measured well and the technician could even tell that baby girl is already 6+ pounds!

She is still in the same position that she's been for the past several weeks with her head down facing backwards, which is exactly how we want her to stay for the big day. It was determined that I'm just measuring small because I'm one big belly and baby girl is already head down making her way toward the exit. This is causing me to look and be a bit smaller than normal, but everything seems to be perfectly normal for my body. 

I felt much better knowing that everything was still on target. I can understand doctors being cautious, but it was slightly annoying to make me worry about something that ended up being perfectly fine. I think sometimes with so much technology, it's easy to say, "oh, we'll just do this test and that test to be sure." Who am I to argue with the doctor? But women have been having babies for thousands of years and haven't always relied on all these tests. Sometimes nature just needs to run it's course. My pregnancy is not going to be the same as anyone else's. It's such a personal thing. I understand though. I've never been pregnant before so this is the first time we are establishing my "normal."

So, hopefully things continue to go smoothly as I enter this final home stretch. It's getting closer and closer and I'm getting more excited to meet her as every day passes. I hope she continues to stay in there a little longer as I finish a few more items on my to-do list. But she's the boss and runs the show! She gets to decide when it's time. I'm counting down the days!