20 Week Bump

Difficult

This pregnancy is kicking my ass in so many ways, it's just completely different to any of the others or at least it seems that way - my memory is so dodgy and pregnancy hormones have an almost amnesic effect so I could just be viewing past memories through rose-tinted specs rather than reality specs! LOL.

It's just been difficult from the start - the meds and their effects, the twin/on off thing, the bleeding, the pains, the morning sickness, the bleeding, the low placenta and the list goes on. I can foresee this pattern continuing the entire 40 weeks and I think that's why it feels like it is dragging so much. My hubster says he can't believe it's been 20 weeks already but I totally can, it seems like longer! I think, as I said to my IF, that that is because we've limped from crisis to crisis and a day seems like a week when you're on constant knicker watch for bleeding or waking up and waiting for the random but painful aches to begin.

Don't get me wrong, I LOVE being pregnant as a surrogate, it gives you a feeling like no other and one that is different to my own 3 pregnancies and I wouldn't change the course I've taken since deciding to be a surrogate for anything. No, but it's different and when times are rough it's hard to swallow and remember the happiness you're bringing and the amazing thing you're being entrusted to do for others. Sometimes it just plain sucks.

I've been in the definite suckage camp this past week, random pains and some spotting will put you in that place. So far though it has passed without any drama and we continue forwards ticking off the days.

Baby boy has started to kick more so this week and that's pretty lovely to feel - something that at present is just between me and him and it's almost like it's his way of saying 'hey tummy mum!' Love it. Won't love it so much when it's keeping me awake or causing me physical pain but like most of this journey, it's a little highlight that keeps you going when everything else is going rough and that's what we take as surrogates - the little things.

Big Scan Day

We had our big scan today and I'm pleased to report that all looks fine, baby is measuring spot on!

It was putting on a show for its daddies, wriggling around, showing us its beautiful face and making sure they had plenty of time to look at how gorgeous it was.

The ultrasound tech took ages looking at the heart, including having me move from one side to the other and switching to doppler flow to view it too and we were all beginning to feel a bit anxious that perhaps she had spotted a problem but it was simply that she was having a hard time viewing one particular aspect that she needed to. There was an audible sigh of relief when she said all was fine.

At the start, my placenta was indeed low and covering the entire cervix, just as we'd feared but suddenly near the end of the appointment she said my bladder had filled up nicely and flipped it out of the way!? She said she therefore didn't need to write anything down on the report about the placenta being an issue but I think that was situational, that because it moved, she couldn't write any different down but that it's essentially a watch and wait thing and since we're booked for a routine growth scan at 32 weeks, they will simply recheck the placenta as part of that anyway and see what's what then. She did however seem unconcerned it was low and covering at the start anyway, and said she had yet to see a placenta that hadn't moved by the time a follow-up scan was done so we're going with that for now. Even if the entire scan it had stayed low, they would do nothing different that have a follow-up anyway.

Baby was lying transverse still but of course there is plenty of time for that to change and it's not a concern at this stage, it does however explain why I'm getting pain so far up and across the top of my uterus because that's where it's hanging out! She was really high up with the probe so my uterus is obviously growing well, she was well above my belly button which was odd since it should be around belly button height but she didn't seem concerned and I'm not either, I know fundal height is subjective and nothing is more accurate than the actual scan and the measurements gained during that - which were all normal.

I should mention that at the start of the scan, the tech asked if we would like to know the gender and we excitedly answered yes! Now, I swore it was a girl because of my sickness, the nub theory and skull theory and I just felt sure it was. M said boy and B said girl. So, one of us had to be right and there was a 50/50 chance...

Straight away the tech announced she could see what baby was and showed us all very clearly that we're TEAM BLUE. Love that part of the scan, it was great to see the look on the boys' faces as they took in the news that they have a son on the way. Seems my body likes boys but this time it's nothing to do with me since my genetics aren't involved!

All in all a good appointment, we all came out grinning and it was lovely to get some much needed good news after last week's scare. There is a lull now because I'm not due to see anyone until 28 weeks, so middle of December and we're going to enjoy every second it and just take in the journey so far.

5am

And it seems a perfect time to blog! LOL. I can't sleep as my oldest is not well and up and down and so I'm awake anyway and of course have things to say about Monday's news.

It is more positive though, I had a pretty down day yesterday where I was consumed by negativity and just couldn't see how this would ever end well and obviously, as we all do, did far too much googling - which never ends well. It culminated in talking to B (IF) and having a bit of a mini meltdown at him, which he took in good grace and instead of giving me as much negativity and emotion back, which he would of been in his rights to do, he listened and we talked things through. I can't say at the time of the call, I was any further reassured or happy but just getting it off my chest helped me.

I decided to go back to Google and visit 'positive placenta previa stories' instead this time though and instantly found some uplifting experiences ladies have had, even with dire beginnings. Yay, not all doom and gloom!

I'm definitely feeling calmer currently, which may or may not last, we will see. One thread I read said that when you first hear low placenta at a scan and especially if you find out after unexpected and scary looking bleeding that you go into what she termed the 'shock and discovery stage', where you Google everything, scare yourself witless, stew and end up depressing yourself with the horror stories and then you come to terms with it slowly after that. I think that was immensely encouraging to read - that I'm not simply being a Debbie Downer, that this is scary times and what I'm feeling is normal and completely valid. I know it may seem an over-reaction to some reading my post yesterday and everyone seems to know someone who has had PP and it turned out fine but when you get the news, when you are actually pregnant and could potentially lose that baby, maybe lose your reproductive organs or even your life and add in that it isn't even your baby but one you have been entrusted to safely bake and deliver....well yeah, I dare you to behave or think much differently at the beginning.

Anyway, so yes I feel a bit happier and more optimistic today. Our plan is not to worry until the official big scan next week where we will get the official grade on what we are dealing with exactly and we also will ask to see a consultant to ask their opinion on things and take it from there. Baby steps, not panicking until we have to is the mantra for now.

Plenty of women have bleeding and a complete placenta previa, the dreaded grade 4 and yet it moves and they are taken off high risk status, complete bedrest is revoked and they go on to have a natural birth. There is no reason that can't be me. No reason.

I read many scary statistics during my time infront of the laptop screen, about 10-25% of babies dying when the mum has PP etc. During my more positive reading yesterday however, I read on the flip side that one half of 1% of ladies die with PP and 9 out of 10 babies survive a PP birth. See, for every negative, you can find a positive - it is just looking hard enough.

I'm still bleeding a small and sporadic amount, again that is a positive compared to Monday's scary stuff and so trying to take it easier. I can't help but wonder if that was caused by lifting 2 of my sleeping and therefore heavy children very late Sunday night - one is 5, the other is 7 so no shrinking violets, and no, there will be no repeat obviously but when I did it, I didn't think twice. I've read that the bleeding has no pattern, it can last for a minute or it can go on for days, you can spot/bleed/spot or bleed/stop/bleed and there is no rhyme nor reason and so I'm not worrying that I'm still seeing stuff and am preparing myself that that could continue to be the case for some time yet and that that is OK too. Remembering what I said yesterday about it not being baby blood but placental blood is helping too, no matter how worrisome it is to see it every bathroom stop, remembering that baby is fine is helping a little.

Anyway, it is now 5:30 (yes I type slow, damn tiny phone) and so I will sign off and try and snatch an hour between medicine time for the sick boy and hope I wake again still feeling as positive as I do now but even if I don't, I recognise now that that is OK and I will get back to the positive point again.

Stomach In Knots

We've had a massive shock, yesterday I woke up to use the bathroom at 6am and was very surprised to see blood. Lots of blood. Red blood at that. Heart pounding, I had to think quick what I should do - in 4 pregnancies, never had this before and so was a bit confused who to call and where to go. I grabbed my maternity notes and first called my community midwife where the answerphone message which said they only with non-urgent matters during office hours. So, next I called the the on-call midwife, which was actually Labour & Delivery at the other hospital here in Bristol, where most pregnant ladies choose to go to and so they told me to call my own hospital's L&D. They said I was too early for them to see and to call the UK health helpline, who told me they would get my out-of-hours GP service to call me back and that Dr told me to contact my own GP surgery because they were soon closing for the night and so couldn't see me themselves. I had to wait a further hour until my surgery was open so I tried to keep calm and called my IPs as they have always said they want to everything, good or bad and they jumped straight in the car and raced to Bristol.

I listened in to baby for some reassurance, spoke with my best friend, R who helped to calm me down and was as reassuring as she always is although I know she's scared for me and baby but she always knows what to say when I need her most.

My GP offered to squeeze me in asap, I knew I'd need a referral to hospital so it was case of just getting that from them. My husband was fab, got the kids ready for school and took them and my IPs arrived to take me to the drs. We kept it light-hearted, laughing a bit, talking things through and agreeing to be positive unless we had cause to think otherwise but it was not how we wanted to see one another again of course. After a wait at the GPs, we walked out with a referral to the Early Pregnancy Unit. One part of that consultation worried me, the GP had tried very briefly to listen to the baby but it's still early and she didn't know where to look or press hard enough and couldn't find it.

At EPU, we were told we'd have to wait 2 hours for the next appt and so I told the receptionist that I'd been bleeding (and still was) since 6am and couldn't they see me sooner and she spoke with one of the midwife practitioners, who told me they couldn't see me sooner, I reminded her that I was 18 weeks odd and wasn't even sure they could see me as I knew their clinic only saw ladies up to 18 weeks. Her eyes popped out of her head when I told her I was over that and she said straight away that I would probably need to be seen upstairs, in the main scan/antenatal/fetal medicine unit but to sit and wait in the unit and see a dr there, who could make the decisions.

We sat around for what felt like hours and the dr then spoke to me, asked the usual questions and said that he would request a scan upstairs and shortly after, he came back and said that I would be scanned at 12pm.

Still bleeding, cramping and feeling very anxious by this point, we all headed up and waited for our appt.  Finally we got called in and were super nervous by now, the moment of truth....

Straight away the tech showed us baby's heartbeat, phew, worst case scenario 1 crossed out. Baby looked absolutely amazing, the picture was so clear and those of us larger ladies know that that's very often not the case but this was crystal clear - we could see the bones of the feet and hands, the stomach, the heart, the complete profile. It was just fantastic, at one point baby looked at us face onwards and it was almost as if it was saying 'what's the problem? I'm fine in here!' The tech did some measurements and baby is growing  perfectly for dates and appeared not to have any issue that would explain the bleeding. We almost got to see the gender early too and the tech was sweet and had a look (which she wasn't meant to do) but said that it was still a bit early and anyway, baby had a foot over the goods so we couldn't tell.

She did however find that my placenta is indeed low. And in light of the fact that there was nothing else that could account for the bleeding, that it was probably that that was the cause. She told us it would be checked at the 20 week scan, next Weds but if it was as thought, I'll be offered an extra scan to see its position around 32-34 weeks. With that, we were free to go. Felt a bit weird not to have any follow-up, no advice about the bleeding, no cervix check. Nothing. But baby was alive so all else could be thought about later.

We all breathed a huge sigh of relief, it had been a long and tense morning and we were all absolutely worn out from the stress.

Once home, I decided to call my lovely and very experienced community midwife for some reassurance and answers to the many questions we all had. I expected her, in her usual confident tone, to say 'oh it's fine. It's common and scary but fine' but she didn't. Her first words were 'ohh, that's not good...' Apparently, it seems like I have what will be graded as such, a Grade 3 (maybe even 4) placenta previa. Also known as major placenta previa. It's where the placenta implants in the lower segment of the uterus, instead of anywhere else. Nothing causes it, it's just one of those things - as my midwife said, it's just bad luck. Since it's situated so close to the cervix it (it can be a Grade 1 to 4 - the latter being the worst) bleeds when the uterus grows and stretches and slightly detaches from the uterine wall.

The plus side is the baby isn't bleeding, the baby isn't in danger from the position of the placenta BUT the bleeding can put the baby in danger in the sense that if I was to experience a huge bleed and they couldn't stop it, they would have no choice but to deliver the baby (at whatever stage) so they could remove the placenta to stop the bleeding. There's no other way in that dire case. The hope however is that whilst I should expect to bleed on and off, several times, over the course of the pregnancy, it wouldn't get to that emergency stage or if it did, not until baby was viable. There's no way of telling how it will go, no way of telling how many bleeds I may (or may not) experience, no way of telling how far this pregnancy will make it so it's just a case of hanging in there and taking it a week at a time - eeking closer and closer towards viability, which according to Google, best earliest odds, of an otherwise healthy baby, would be around 25 weeks. That's my current goal, if I have any control over anything, which of course none of us do but in my mind, if I get to 25 (which is still a potentially scary 6 weeks away), I will breathe a little sigh of relief.

My midwife said that from 21 weeks, if I experience anything worrisome, I can head straight to L&D, cutting out being given the run around like yesterday and that was good to hear. At least at L&D the drs, equipment, scan machine etc are all in one place.

I've been unable to think of anything else since yesterday, I keep randomly finding myself tearful and thinking about the what-ifs, like B (IF), I need hard facts to work with and there are few for this condition and so that adds to feeling out of control.

It seems very probable that I will have a c-section, this grade of placenta is highly unlikely to move enough for a vaginal birth and even if it does, the risk of heavy bleeding is quite high regardless. The risks of a massive bleed and the need for blood transfusion during birth is high, the risk of needing a hysterectomy is small but still a possibility. I'm petrified.

Worse still, it could be necessary for me to be admitted to hospital during the last 6 weeks of my pregnancy, as you are most at risk of a huge hemorrhage at that point and baby would need to be delivered asap - like emergency c-section, under general anaesthetic. I cannot be away from my own babies, I live and breathe them and the thought of that about kills me. I refuse to even entertain that happening at this point and will have to deal with it, if and when it happens. It does appear likely that this baby will come around 34-38 weeks though, from what I'm reading. Google says not to be on my own from now on, incase I need to get to hospital without delay and that also throws my potential plan to spend Christmas with my mum in Scotland out the window too but at least she is about 20 minutes from the nearest maternity facilities if I do decide to go. Again, will need to think about that closer to the time, when we've had our next scan and I can see how the bleeding situation is going to pan out.

I just feel like everything I thought would happen, everything I had planned for the pregnancy and delivery has just been yanked out of my hands. I'm at the mercy of Mother Nature. My poor IPs do not deserve this, why can't it be smooth sailing, haven't they worked hard enough to get this far? But, it is what it is. Although not common, this condition isn't always dire and doesn't always have a negative outcome and there's no reason we won't be in the positive and happy category and that's what we're trying to focus on for now. I'm still bleeding this morning, it appears (touch wood) to of slowed down a bit but it's still worrisome. I've decided to not freak every bathroom trip, it is blood, we know where it's coming from, we know that it will do its thing regardless of what we say or do and unless it's much much worse, we just have to stay calm and ignore it - so that's the plan. Which I do well with, until it all just comes back and I feel like I've been punched in the gut all over again (figuratively).

Looking much further forwards, which anyone who knows me knows I do a lot, this has thrown up questions about a sibling project or infact any more surrogate babies. I already knew my risk of complications (ironically of bleeding specifically) have increased due to the number of babies I've had already and my age, but now the risks increase again with placenta previa as it is likely to happen again and the risks increase if I have a c-section in many different ways too. Perhaps this pregnancy is nature's way of saying is enough is enough, (fingers crossed) 5 happy and healthy babies is more than enough for anyone to of been fortunate enough to bring into the world so maybe this is all I'm meant to have. Of course, that's dependent on so many things and something I can't even truly being to process at this point but it has crept into my mind since events of yesterday.

For now though, we concentrate on the here and now and deal with whatever it may bring. Please do say a prayer, or send some good thoughts, or whatever it is that you do in times of worry or crisis because we could really do with some right now. I'll be back next week to update on the scan because hopefully there will be nothing else to update about in the mean time.

Pang Of Regret?

I feel like I am walking through treacle most days and so breathless and tired,  which is not helped by the fact my children never seem to sleep and so neither can I.

A trip around the supermarket leaves me drained, I have to stop every aisle or so and find the energy to move on again. Walking my kids from the car to their classes and back leaves me feeling like I've run a mini-marathon.

Feeling like perhaps it wasn't such a smart idea to get pregnant so quickly after surrobaby 1 was born and that I'm now paying the price.

Yes it is another late night (currently 11:30pm) and I'm positive that is not helping my mood but pretty fed up currently and in the name of keeping things honest and real on my blogs, you unlucky readers get to listen to this mini-pity party.

And IPs, they try so hard to be sympathetic and 'get it' but how can they truly? They can veg of an evening, they can nap whenever they are able and wish to, they get to go to bed when they want and have an uninterrupted sleep, heck, they even get a lie-in if they desire - none of which are happening in my house. So forgive me if I'm a little resentful that I'm suffering sometimes 17 hours a day, (my kids do let me get some sleep), 7 days a week and my life is turned upside down, all the while doing something I will get nothing really out of and for others whose lives continue on as almost normal at the same time. Bit galling I am sure you can agree.

How many times can they ask me how I am, to hear me reply 'tired' every single time, without becoming a bit disinterested? Almost like it is just something I say, without true meaning. What I want to reply with is 'I am shattered, almost on my knees and not able to function properly tired. Do you understand how that feels?' but instead I settle for the 'I'm good, tired' staple answer instead.

OK, finally silence has descended over my household so I guess now I finally get to snatch a few hours rest - well inbetween the insomnia I always get when pregnant, appearance of heartburn, gnawing stomach pain and waking to pee almost every hour. Yay, lucky me.