Group B Strep

I had my 37th week appointment today, which went okay. I finally got to meet the last of the midwives, and she was really nice and easy for me to talk to. I feel better now that I've met all of the midwives, and would be happy having any one of them there with me when I go into labor.

Today I found out the results of my Group B Strep (GBS) test that I took last week. Unfortunately, it was positive. This means that I am going to have to be given antibiotics during labor. I guess it's not really that big of a deal, but I really hate needles and I am bummed that I am going to have to be hooked up to an IV. But it's better to be safe, and being on the antibiotics decreases the chances of the baby getting a GBS infection from about 1/200 to 1/4,000 if everything else during labor is healthy and normal (If a baby gets a GBS infection they can suffer from conditions such as meningitis and even death). The antibiotics will need to be administered as soon as my water breaks, if my water happens to break before I go into active labor. This, however, only happens to a small percentage of women. But if I hadn't had tested positive for GBS and my water broke, I would be able to stay at home until I was in active labor as long as the amniotic fluid looked and smelled normal. Otherwise, I won't have to be in the hospital until I am in active labor (contractions 3-4 minutes apart). They like to get a dose of antibiotics in at 4 hours before the baby is born. So if I am in labor for an extended period of time, they will keep administering the antibiotics every four hours. The midwife said that it takes about half an hour for the antibiotics to go in, and that I will be able to walk around with the IV if I want. After it is administered, I will be unhooked and free. I will still be able to labor in water and even give birth in water if that's what I choose to do. So overall, it's really not that big of a deal, I just have to not be a wimp about having something stuck in my arm, which I think I can do. The midwife gave me a great handout about how I can attempt to clear GBS from my system so that if I have the baby anytime after 41 weeks, I can get tested again and possibly not have to have the antibiotics. Here is what the handout said:

GBS is a bacteria present in the bodies of about 30% of healthy adults. There are natural treatments to help eliminate GBS and restore healthy balance to the body. These herbs strengthen your immune system and help to restore normal vaginal flora. You may choose to do some, or all, of the following remedies. Doing so will increase the chance of testing GBS negative and avoiding antibiotics in labor:

• Acidophilus/probiotics, 4-6 capsules per day, or eat a lot of plain cultured yogurt every day

• 500 mg of vitamin C every day

• Echinacea- tincture, capsule, or tea, as directed on product

• Bee Propolis, as directed on product

• Eat a lot of fresh garlic every day

Ways to get garlic down if you prefer not to cook with it:  

~Chop a clove of fresh garlic and mix with a teaspoon of honey. Swallow this without chewing it.

~Make a garlic elixir by blending 1/2 cup of honey, 1/4 cup of apple cider vinegar, and a bulb of fresh garlic. Take 1/2 teaspoon up to twice a day or mix with olive oil and use as a salad dressing or bread dip

~Take garlic perles (over the counter) according to the dosage on the brand you purchase.

I kind of wish I had known this information beforehand so that I could have tried to test negative for GBS the first time around. But I guess GBS comes and goes through peoples' systems normally, and just because you may or may not have it early on, things can change at the end of pregnancy. Even still, I probably would have actively been trying to prevent a positive result throughout my pregnancy. I had a very bad experience going on antibiotics a couple of years ago, where there was a chance I might develop Lyme disease (I had a questionable rash on my leg after working in a high risk area) so they treated me to prevent contraction of the disease. The first antibiotic I took made me sick to my stomach and I couldn't keep it down. So they tried a second type that made me more susceptible to sunlight (a bad thing when you are working in a salt marsh 8-10 hours a day in 95 degree weather), and I was able to keep it down though it made me feel kind of crummy still. I also had to wear long sleeves, a hat, gloves (my hands got sunburned the first day I didn't wear any, despite putting sunblock on them every hour), and lots of high SPF sunblock. The antibiotics gave me horrible digestive issues and yeast infections off and on for over a year, until I found some great vitamins that helped me get my system back to normal (New Chapter Organics). So now I am a bit nervous about having to deal with antibiotics again, though now I have a better idea of how to get my system back on track than I did last time I dealt with this.

Besides this GBS annoyance, everything else is going well. My blood pressure is normal, and I am measuring normal at 36.5 inches (height of fundus). The baby's heart rate was in the normal range, and he is in a great position (though he is still moving around at this point). The midwife was giggling because she felt how his feet like to push right into my ribs. Hopefully everything stays on track and the baby and I are healthy and happy all the way through labor and childbirth.

36th Week of Pregnancy Update

36th Week of Development

It's hard to believe that today is the final day of my pregnancy before I am considered full term. It seems like it went by too quickly to me, but we are feeling prepared for Mattimeo's arrival at this point. The nursery is all set (I am going to save pictures of that for the next post) and we have everything we need; I just have to pack my hospital bag and have that ready. This is all very exciting and unreal.

Lots of fun things thing report from over the last week or so. To start with, last Friday Robbie had a "dadchelor party". This was something I read about in an article online (http://newsfeed.time.com/2011/06/15/dadchelor-parties-first-time-fathers-party-hard-before-babies-arrive/) and shared with Robbie. Of course he thought it sounded like a great idea, and made plans right away. Basically a dadchelor party is one last time to hang out with all your guy friends, get drunk and do whatever the heck you want before you become a father (a lifetime and life-changing commitment). It as not as though he still won't be able to hang out and have fun with friends once he is a father, but it is a pretty cool way to celebrate the end of an era and the start of a new one. Our awesome friend Gib agreed to host a party at his house, and Robbie had great time hanging out, drinking, eating yummy snacks and playing video games with his best friends. He drank himself into quite a stupor, and I ended up picking him up at 2:00 in the morning because he wasn't in a state to walk home (I didn't mind because I had just got up for a snack anyways). When I talked to him in the morning though, he reported that he had an amazing time, and I am really glad he did that. I am also glad he had the party sooner rather than later, because the last thing I need is to go into labor when my husband is off somewhere too drunk to drive me to the hospital!

On Sunday, Robbie and I went to one last class at the Birthplace- Safe starts: Infant safety and CPR. The class was about four hours long and covered a ton of material. First we went over home safety. We watched a video about all kinds of safety issues in the home, then had to fill out a form to rate how safe our homes are for babies.The teacher gave us some great handouts that outline all the things we saw in the video which will be a great reference when we need to childproof our apartment. The second part of class focused on CPR and foreign body airway obstruction techniques. We all had our own dummies to practice giving CPR to babies and small children, as well as to assist with choking babies and children. They have really simplified things since the last time I took a first aid class which makes the thought of having to rescue someone a bit less daunting. Now, no matter if you are giving CPR to a baby, child or adult, you are supposed to give 30 compressions, check their airway, and give 2 breathes. We practiced lots of different scenarios, which if nothing else, helped us to remember those numbers to start to make it second nature as to what needs to be done in an emergency. Finally, we discussed car seat safety. A lot of the stuff about car seat safety was review for Robbie and I since we already went to a car-seat safety check a couple of weeks ago, but it was still nice to go over. There is so much information about infant safety, it's almost overwhelming. For the most part though a little common sense will take us a long way. I think that class was really great and gave us important information that we wouldn't necessarily have thought of on our own...I am glad we went.

Thursday I had another appointment at Back Cove Midwives. This time Robbie decided to work from home for the day so he could go in with me, which I was really happy about. Part of this visit was to have a Group B Strep Test. This just involved me going into the bathroom and taking a sample with a sterile swab of inside my vagina and along my perineum. Group B Strep is a bacteria found in some people's digestive systems, but because of the relative closeness of the anus and vagina, sometimes this bacteria can pass to the vagina. This bacteria is harmful to infants, so if pregnant women test positive, they are usually set up with an IV the pumps antibiotics into them while they are in labor to prevent the baby from getting sick (For more information: http://www.americanpregnancy.org/pregnancycomplications/groupbstrepinfection.html). Only about 25% of women test positive for the bacteria (and it seems to be random who has or doesn't have it), so hopefully I test negative. I would really rather not go through labor with an IV hooked up to me, as I hate needles and it freaks me out to have things stuck in my arm. I will find out next week what my results were. The rest of the appointment went well. Robbie and I have written a birth plan, which outlines how we want different situations to be treated through labor, childbirth and beyond while we are in the birthing center. It's main advantage is that any new person who comes into my room knows that we are planning on having a relaxed, natural birth and prevents people from asking me millions of questions while I am focusing on birthing a baby.We went over our birth plan with the mid-wife and she helped us to cross out things that are unnecessary to write down because they are done automatically at Mercy, as well as offer any suggestions she had. Now I will make a final draft, and I will give copies of that to the midwives next week to keep in my file as well as bring copies to the hospital. The normal part of the appointment went well. Both the baby and I are healthy. The height of my fundus this week was 35 inches, and the babies heart rate was normal. She noticed that he had dropped down quite a bit. She said he is not fully engaged yet, but definitely low and flirting with the idea. She told me to try to keep him in there until at least 38-39 weeks because even though 37 weeks is full term, there can still be complications.

I believe this is what you would call "nesting"

The rest of the week was great. I got to see my good friend Josh on Friday, who I haven't seen since I became pregnant since he was working on finishing up his Master's degree in Florida and spent a little over a month visiting Zambia (where he had traveled to during the peace corps a couple years ago). We went for a nice, long walk to catch up and it was really great to see him again. Its nice when seeing an old friend feels so natural as though no time has passed at all. Friday night was the first Friday art walk in Portland. Our friend Gib recently acquired some studio space and was on display in a gallery. So Robbie and I went to go check it out and ended up hanging out there most of the night. While we were there we met up with another old friend that we hadn't seen since college, which was really great.

The state of our balcony garden as of now

The state of our balcony garden as of now: angel's trumpet

The state of our balcony garden as of now

The state of our balcony garden as of now: basil and rosemary

The seeds I planted at the beginning of the season are coming up

The state of our balcony garden as of now: begonias

Some of Gib's art up at the Dooryard

Finally, on Saturday Robbie and I made a trip to Waterboro to go strawberry picking at Doles Orchard. This is the farm I used to work at off an on: once for a summer, and then again in autumn a couple years later. The owners, Nancy and Earl, are really great people and it was nice to see them again and be back on the farm. They are having a really great year for strawberries fortunately, and we picked a flat of berries in about 1/2 hour. Robbie's mom and dad came with us, which made the experience even more enjoyable. After picking berries we went to his parents house to visit and do some laundry. The cloth diapers we got need to be washed a couple of times before use, so we wanted to do that in order to get ready for the baby's arrival. Robbie also helped his parents move wood down into their basement, then played Borderlands with his Dad while I finished up laundry and took a walk with his mom to the lake to dip our feet in the water and get some exercise. After visiting his parents, we went to see my Dad and Sue for a little bit, then went to see my brother and his family on our way home. My brother's in-laws are having a big campout at their house for the holiday, so we got to see lots of people and cute dogs. Our nephew Bryce is 8 months old now and is growing into a really handsome and happy little boy, it was good to see him as well as Brian and Nicole.

Robbie's mom picking berries at Doles Orchard

Robbie's dad picking berries at Doles Orchard

Robbie eating berries at Dole's Orchard

Me picking berries at Doles Orchard

Picking strawberries (36 weeks pregnant)

Strawberries at Doles Orchard

Strawberries at Doles Orchard

Robbie picking berries at Doles Orchard

Strawberries at Doles Orchard

Robbie and his Mom moving wood

Robbie transporting the wood

Robbie's dad bringing the wood down to the basement for their heat this fall/winter

Drying come of our cloth diapers on the line

Doula Tea and Glucose Screening

26th Week of Development for Baby

Happy Earth Day! Well into my 26th week now, I have been growing at a much faster rate, mostly because our baby is going through a bit of a  growth spurt of his own. Robbie joined me for my appointment with the midwives today which he hasn't been able to do since my my very first appointment. It was good to have him there for support and also to be able to hear Mattimeo's heart rate, and how much stronger it is now. I got to meet with a new (new for me that is) midwife today, Jen. Like the others, she is really nice, knowledgeable and approachable. We talked about her opinion regarding doulas, circumcision, pediatricians, and my rate of weight gain. It turns out that she is using a pediatrician that is part of the same group of pediatricians that our pediatrician is in for her own children and had nothing but good things to say about their practice. That was very reassuring to hear. My weight gain is right on target; apparently the baby is going through a bit of a growth spurt right now which means I also am. I have gained about 15-20 pounds so far. He is now just under 2 pounds and his heart is beating at around 130 bpm. The midwife felt around my belly to get an idea of what kind of position the baby is in. She could feel his feet up high above my belly button, but couldn't quite make out where is head is. When she listened to his heart beat though, it was loudest way down low in my uterus, which means the baby is probably already in or nearly in an upside down position. This is great because gravity is already working to get him into a good birthing position. She said once he manages to get upside down, he will most likely stay that way. I was quite relieved about this because I was nervous about having a breach baby. I was breach when I was born, and my mom had a really difficult labor. Plus I know in most cases now, a breach birth will lead to a cesarean section, which I also do not want. So if my little boy is really on the right track, I am a very happy Mamma to be. Plus, that would explain the strange sensations I have been having very low in my uterus...like the baby is punching my vagina. Turns out, he basically is. His little tiny fists and feet have been busy dancing away in my belly, bumping anything within reach. It's such a wild sensation to feel him moving around inside me.

Part of my appointment, and the main reason I convinced Robbie to work from home so he could join me, was my glucose screening test. The purpose of this is to check for gestational diabetes, and they test this in every pregnant woman. The test involves finishing eating breakfast at least 2 hours before my appointment. Then, an hour before my appointment I had to drink this sugary orange drink within 5 minutes and record what time I finished at. Drinking this made me feel like a humming bird. Exactly an hour later they drew some of my blood. The will my blood into a lab to test for any signs of diabetes. If my sugar levels are off, I will have to go through further testing called a glucose tolerance test. I really hope everything comes back normal, I really don't like being poked with needles and would rather avoid any more needle encounters. They are also going to use my blood sample to check my iron levels again. At this stage of pregnancy, the woman's blood is at its most diluted point, and then want to make sure that the red blood cells are still able to hold adequate amounts of iron. If the iron levels are low, I'll just have to take an additional iron supplement. Hopefully my iron levels are fine too. As a vegetarian I have gotten pretty good at being able to tell if I am getting enough iron because when I don't I get more fatigued and tend to bruise very easily. I haven't noticed any of those symptoms, but being pregnant means I have a whole new body, so who knows. The reason why I wanted Robbie around for these tests is because I still get kind of queasy in the morning depending on what time I wake up and what types of food I eat. I was concerned that I would get really nauseous and not be able to drive myself. Fortunately I only got a little queasy and I was fine, but it was nice to have him there anyways.

I have mentioned the term "doula" in a couple posts now, but I'm not sure if everyone knows what that is. I certainly didn't know what a doula was before I was pregnant. A birth doula is a person who is trained and experience in supporting women and their partners during labor and birth. They are there to focus entirely on the woman, while the midwives and doctors need to also focus a lot of their attention on the baby. Doulas do a number of different things depending on what you need them to do. They can give you massages, help you find comfortable positions to labor in, advise your partner, make sure your birth plan is being followed, give encouragement, advice and any other sort of help you need. As one doula I met put it, "We are basically a physical form of google, so that when you are in the throws of labor and child birth, your partner can focus on you and not worry about trying to remember what he learned in class or read in books". According to Pregnancy Childbrith and the Newborn, a guide by Durham et al. (2010), studies show the following benefits from having a doula:

• Shorter labors, with less need for medication to speed up labor
• More spontaneous vaginal births (that is births that don't require forceps, vacuum extraction, or cesarean delivery.)
• Fewer requests for pain medications
• Less dissatisfaction with birth experiences

We have asked a couple of the midwives what they think about doulas. One midwife said that doulas are really fabulous to have around. She said sometimes there are a lot of births occurring at the same time, and the midwives and nurses might need to be in and out more often. In those circumstances, the doula would stay with us at all times and we would have constant support if we wanted it. She also pointed out that it can be very beneficial to the partner to have someone there to act as support, because no one really knows how they are going to feel seeing their loved one giving birth for the first time. The other midwife was also supportive of having a doula, although she said in her experience they have a great system at the birthplace where the midwives are usually around a lot and the nurses almost act as doulas. She said of course the nurses need to also pay attention/monitor the baby, but that they are very supportive and both midwife and nurse will be there to coach and support both partner and mother. She said that with regular doctors, a doula can be a really great idea, or even if we were having a birth in the hospital. But because we chose to have midwives who are more focused on the overall well-being of the mother than a doctor might be, and because we are giving birth at a birthplace that really cares about meeting the mothers needs as much as possible, we don't need to be so worried about finding a doula. She said while having a doula would be nice, we will be just fine without one.

This past Sunday, Robbie and I went to a doula tea at Birth Roots in Portland. Birth Roots is a great resource for expecting mothers and mothers who have babies. They offer lots of different classes, support groups, and generally act as a place where mothers can get together and bond as a community. The purpose of the doula tea is for doulas and pregnant women to get together over tea to discuss the roles and benefits of having a doula. It gives the pregnant woman a chance to learn about doulas, to ask questions, and to meet a bunch of different doulas from this area with a range of experience, expertise and personalities. The tea provides doulas with a chance to socialize with pregnant women and meet potential clients. When Robbie and I went this weekend there was only one other pregnant woman their, and she just happened to be a really awesome lady from my prenatal yoga class who is due just a week earlier than me. Their was a range of doulas there...some of them just finished their training and hadn't attended their first births yet; some have been doulas for 10 years and can't even count how many births they have been to. It was really awesome hearing from all of them and asking questions.

Robbie and I met a couple of them that really appealed to us (we felt like our personalities and ideals meshed nicely), and we have their contact information if we try to pursue them. Currently, we are on the fence about whether or not we want to hire a doula. First of all, they cost money. Their prices range from $300 to $1000. Some of the ones just getting out of training volunteer their services, but honestly neither Robbie or I were very keen on the idea of being our support persons first birth. While I'm sure they would do a fine job, it would be nice to have someone with more experience. Therefore, we need to figure out if we have the money to hire a doula. We also aren't even sure if a doula would be completely necessary for us. We are signed up to take hypnobirthing classes starting next month, and the main idea behind hypnobirthing is to be calm, relaxed, and really focus on what is happening in your own body. You are supposed to be really aware and focused on your birth, and may not necessarily need a lot of attention from more than just your partner. If we find after taking the hypnobirthing classes that it is something we are really comfortable with doing on our own, we might be fine without the support of a doula. But like I said, we are on the fence. I think it would be great to have a doula, but I'm not sure we can afford one or that it is completely necessary for our needs yet.

First Ultrasound

On this very snowy day, Robbie and I had an appointment for a meeting with a genetics counselor and for my sequential screening.  During the meeting with the genetics counselor we went through our family histories and descent and discussed any risks our baby might be faced with. In particular we were looking at the chances of our baby developing IHSS, which is a heart condition that runs in my family. Fortunately, since my mom and siblings don't have the disease, my chances of passing the disease to our baby appear to be very low. So that was good to hear.

The sequential screening consisted of an ultrasound and having my blood drawn. This was our first ultrasound, and it was an incredible experience. I thought it would be difficult to see the baby, just because it's always been difficult for me to pick out babies in other people's ultrasound pictures. But we saw our baby clearly right away! At 12 weeks and 2 days, it is amazing how developed he/she already is! The technician was very pleased because she said the baby was in a perfect position for us to see and for her to take measurements. She said that is very rare for babies to be so well positioned, so we were really lucky. Our baby was kicking and wiggling around; very active. He/she also started using its little fingers to play with its nose which made us all laugh. Based on the progress of the babies development, she estimated that I should be 12 weeks and 2 days along, which is exactly how far along I am based on the date of my last menstrual cycle. So my estimated due date of July 25th is actually a very good one. The baby is 5.5 cm long and has a healthy heart rate of 165 beats per minute. We could see the flutter of the baby's heart which was beautiful, as well as its developing brain. We could also see each of its tiny fingers and toes. She ended the ultrasound by showing me my bladder and how full it was (you are supposed to have a full bladder during an ultrasound) and said she was going to stop now so I could go pee. Having that ultrasound today and actually seeing our baby for the first time was one of the most wonderful experiences in my life so far. I can't believe there is a tiny person dancing around in my tummy right now. I am so glad that our baby is healthy, strong, and beautiful. Here is a video of our ultrasound for your enjoyment, as well as some pictures.

12 Weeks

12 Weeks

12 Weeks

Heartbeat

Today Robbie an I had our second visit at Back Cove Midwives, at 10 weeks and 3 days along in our pregnancy. We were a little worried about getting there because my eyes were killing me this morning (it took me a half hour to be able to open them for any extended period of time) and Robbie's vertigo was really acting up. We made quite the pair; I had to drive because Robbie couldn't turn his head quickly, but I had trouble seeing even with sunglasses because my eyes were so sensitive to the light. We made it safely though.

This time we met with one of the midwives, Laura, which was really great. She was very kind and knowledgeable, we both felt really comfortable asking her all of our questions. We found out that the blood and urine tests I had last week were all normal, which is great. I am glad that I am getting enough iron as a vegetarian. I also found out my blood type, which is A positive, which was a relief (I know Mom is negative and had to have a shot). Then she gave me a physical, and I am fit and healthy. Robbie got to stay in the room for my physical which he declared was less awkward than he expected. We thought it would be a good idea for him to stay since I ought to get used to having him in the room while I am feeling compromised so I will be more comfortable having him with me when I am in labor. 

After the physical, she took out the doppler so she could try to find the baby's heartbeat. She found it pretty quickly, and Robbie could hear it, but I couldn't. Then something made me laugh which made the static sound go crazy, which made me laugh even more, which forced her to take the doppler off my tummy to save our ears hehe. Once I calmed myself, she tried again and this time I heard it loud and clear. It was so magical! Our little baby's heart was beating 170-171 bpm and sounded so strong. I wasn't expecting to be able  to hear it because part of me still had doubts that there really is a person growing inside me. But there was his/her little heartbeat, we are really going to have a baby! I feel like I am floating in happiness. What an amazing experience! Robbie was smiling from ear to ear, we are so excited!

Today we also had to decide what prenatal screenings we want to have done. The midwives believe that parents should be able to decide for themselves what types of screenings they want, and on our last visit gave us a ton of information so we could do our own reading/research and decide which ones we wanted. We decided that we might as well do all the ones that our insurance covers since they all seem very useful. The midwife also said she is going to set up an appointment for us to meet with a genetic counselor if we want (which we do) since a heart condition (IHSS- click for more info) runs in my family. Here is a description of the screenings we are going to do:

Sequential Screening: Done between 11 and 13 weeks. Sequential Screen uses a high level ultrasound to measure a portion of the fetus' neck in combination with a maternal blood test to determine your risk of having a baby with an abnormal amount of chromosomes, a condition which is linked to certain genetic defects such as Downs Syndrome and Trisomy 18. The ultrasound may be done wither trans-abdominally or trans vaginally. This screening can identify 83% of pregnancies with fetal Downs Syndrome and about 90% of pregnancies with fetal Trisomy 18. A pregnancy with 'screen negative' results will be followed by the AFP test to screen for open neural tube defects and for further reassurance regarding other birth defects.

Alpha-Fetal Protein Profile: The AFP Profile is a maternal blood test which checks a pregnant woman's leveles of certain substances made by the baby to determine if the baby is developing normally. The AFP Profile is drawn between 16 and 18 weeks and can help to identify 5 out of 6 cases of Spina Bifida, almost all cases of Anencephaly, 3 out of 4 cases of Downs Syndrome and 3 out of 5 cases of Trisomy 18. A normal or 'screen negative' result is usually gained by also obtaining a High Resolution Ultrasound at 18 to 20 weeks.

High Resolution Ultrasound: Performed at 18-20 weeks. This ultrasound looks, as closely as the baby's position will allow, to identify such organs as the heart, lungs and kidneys, as well as other structures such as the palate and the spine. Sometimes views are limited and you will be asked to return to get a closer look. If the baby's position is such that the genitals are visible you can choose to know the gender of your baby if you'd like. The scanning is done trans-abdominally.