Monday, January 7, 2008

Oh, and A Baby On the Way

It's been over a month now since I last referenced my pregnancy on the ol' blog. We are one month and counting from the estimated arrival of sweet baby James and I've had two midwife appointments over the last many weeks and a general practitioner appointment this morning that I've neglected to mention.

Both my midwife visits were fairly routine. One was on Thanksgiving Day and the other a few days before Christmas. The office does not have a nurse staff so the midwife does all procedures for the visit - blood pressure taking, fundal height measurement, palpitations for position and checking the fetal heart rate. In the four appointments I've had, I've been impressed by how they always start on time if not ahead of schedule, how technically detailed the midwife's questions are regarding how I've been feeling and despite being on a 20-minute per appointment schedule how I've never felt rushed through my visit. A student midwife has assisted at two of my appointments and I got to see her practice using a wooden Pinard Horn to hear the baby's heart beat. It reminded me of my uncle who would teach his nautical students to use the old school nautical navigation tools less their electrical navigational equipment ever gave out.

Certain things are interesting regarding the standard of care. Testing for gestational diabetes is not part of the standard prenatal screening process. At the midwife visits (but not the general practitioner visits) patients perform their own urine tests for protein and sugar and are instructed to relay abnormal information to their midwife if the color strip is off. My midwife has never asked me to step on a scale at any of my visits, though my GP today gave me the option if I wanted to be weighed. Because I'm Rh blood factor negative and Michael is Rh-positive, I had blood drawn today by the GP to check for antibodies; in the States I believe they do this test earlier. And testing for Group-B Strep is not standard. I asked my GP about it today and she said it was elective. I elected to be tested because it takes 10 seconds, is hardly invasive and if there is a problem I'd rather know about it up front and deal with it. And while in the States I'd be seeing my doctor every week from here on out, my next midwife appointment isn't until week 38 (I'm 35 weeks plus three days as of today) and I'm not sure when the next visit after that will be.

In general I'm feeling fine. This has been an even easier pregnancy than the first one. I'm starting to get the standard tiredness, swelling, heartburn, trouble sleeping and self absorption that tends to come this late in pregnancy. And every day I am increasingly taking on the shape of a water barrel. At least this time I know that post-birth I'll shrink back down to normal compared with the first time around when I had the serious suspicion that was just a comforting lie people tell huge pregnant women.

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