38 weeks measuring 32

[Dineapple]

Hi! I am new to the forum and getting close to my due date. I moved to FL recently and found out VBAC is pretty much a no-go here, and that sealed the deal for me as far as choosing UC. I was seeing a midwife home-birthing group until around 20 weeks and I was measuring normal up to that point, and was on track baby size wise at my 18 week ultrasound. I have been UP since then, mainly keeping an eye on my bp since I have a history of pre-eclampsia. 

Anyways, I am 38 weeks as of this coming Monday. I just measured my fundal height for the first time because people keep telling me how small I look. I measured at 32... 

Opinions would be greatly appreciated. I am super apprehensive to go to an OB in the area as I am afraid of getting sucked in and never escaping. Not to mention the fact that every office I called when I first got into town said it would be a problem for me to become a new patient so far into the pregnancy and that I would have to send them my records, (of which there are little), and then get approved to be seen by the doctors. Is it just me or is it ridiculous that a doctor would have to approve you as low risk enough to be a patient? I don't get it and it was just one more push in the direction of UC.

The only midwife group here won't see me because I have a prior c-section :/

I suspect the baby might be transverse at the moment as he has not made up his mind yet about position, (actually I think he is sort of on a diagonal), but I could be totally wrong about that.I have an anterior placenta and it is hard for me to ever get a good FHT with my stethoscope, but he moves quite a bit. I am paranoid that he doesn't move enough, but since I really don't know what is normal and I do feel him strongly throughout the day I haven't been too worried. 

What would happen if I just showed up at the hospital to have things checked out? Any fibs I could tell them to make them more apt to check things out and then send me on my way without them pressuring me too much? I know my personality and I tend to bow to any sort of authority rather than to cause a stink, so I don't want to put myself in a position where I will be steam rolled by freaked out medical personnel. 

I want to UC so badly, but of course I would feel terrible FOREVER if there turned out to be something wrong that I could have caught beforehand. I am so torn right now. I so wish the medical community was more accepting of alternative birthing choices so that I wouldn't feel as conflicted about getting something as simple as a reassuring check up.

Thanks for reading and hopefully responding :) This forum has been a great help to me and I am sure countless other lurkers like me.

~JC

[MotheringBliss]

Hi Dineapple Welcome to the Forum!

What a hassle Florida seems to be eh?  When I've had specific concerns that needed diagnostics, I found that some pregnancy centers are very respectful of your wishes.  Maybe there's one near you...

http://www.lifecall.org/cpc/florida.html  I've experienced anti-help from hospitals however.

I had a petite baby and all went well. As long as there are not other factors interfering with oxygen/nutrient/fluid supply...(Spinal alignment, diet, drugs, placental position, GD)  There is alot of fear mongering within the medical community regarding IUGR, and it's easy to become pressured into excessive monitoring/inducement and such, so your concerns are well founded. Maybe focus less on measurements and more about how you are feeling.  Weak, lethargic, light headed, stomach problems?  There may be issues needing addressed.

Preeclampsia can be handled through diet/supplementation...http://www.bastyrcenter.org/content/view/612/

                                 http://www.blueribbonbaby.org/

Your babe's position can be influenced by yoga, acupressure, inversion positions...http://spinningbabies.com/

You have any other support Mama?

[Dineapple]

Thank you for the reply :)

Really, I feel pretty good considering how far along I am. The baby is definitely trying out new positions almost every day, so I am not too worried about position yet. I got him to flip a couple of days ago with the hot pack down low ice pack up high trick, but it only lasted a few hours before he turned again. My bp has been great except for one scare where I had a migraine and moderately high readings throughout the night a week or so ago. I usually range in the 110's over 70's and that night I was 130s/80-90s. That night is really what started me worrying at all, before that I had complete confidence. I am doing the high protein diet, (actually I had been feeling so good that I had slipped in that a bit, but I am back on track now). My bp has since been back to normal.

I will try calling one of those centers in my area to feel them out, thank you for the info...

When should I be concerned about IUGR? I am afraid they might see a baby on the small side of normal and blow things out of proportion in order to get me to have a medicated birth. 

Sigh, the hardest part by far of this UP/UC are the little nagging doubts. I have a beautiful water birth experience with my SO all set up and waiting, I can't imagine the disappointment we will feel if I bail at the last moment from fear and everything turns out fine with the baby, or the opposite happens and I stay home and it goes poorly. Ironically, I moved from a much smaller town out of state and just assumed that moving to the large city I am in now would mean MORE options. So so wrong. 

My SO is wonderful, and super positive and supportive about having a UC, or changing my mind if that is what I decide. He spent a whole 2 days being horrified at the thought of DIY birth, but he listened to the facts and my intuition and was right on board after that. The rest of my family is tolerant but not what I would call supportive, which I understand. 

Alright, well thank you again and if anyone else would like to weigh in that would be fabulous!

[cameragirl]

Has the baby dropped? That will cause a dip in the fundal height measurement. That alone can be a 4 week difference.

[Hallel]

Thats too bad no one is there to help you birth without pushing you into other things!

Thats all the advice I have! Good luck.

[Buzzbuzz]

When I had two small incidents of vaginal bleeding, I went to the ER and was given ultrasounds both times. 

Perhaps you could use something like that as a basis for getting checked out? Show up on a Sunday (so have an excuse why you're not at the doctor's office) with something along the lines of "some minimal bleeding, but came into the ER in the interests of getting things checked out."  You could even go to another town (where the hospital wouldn't recognize your town's doctors) and claim that "Dr. Smith" is your regular OB and you will be getting in to see him on Monday if you feel they are pressuring you.

But it does sound like a good idea to get checked out.

[holly6737]

I would want to get that checked out, personally. A 6 week difference is quite significant. It's not true that IUGR babies have to be c-section babies. IUGR babies can definitely come vaginally and you don't have to be hooked up to everything either. I would have it checked out just for the purpose of knowing if you should have extra people on hand, a different plan for after the birth, in the event the baby has complications. So, several options for you. First, is there a teaching hospital close to you? A lot of times, teaching hospitals that have OB residency programs will have resident clinics for people who can't find prenatal care elsewhere. There you would also have the benefit of having a team with the most up-to-date research to help you. IME, resident clinics take everyone- self pay, illegal immigrants, no risk too high, "late to prenatal care", etc. If you don't have a teaching hospital close to you, you could also go to the ER. All of the hospitals I've worked in have had a policy that after 19 or 20 weeks gestation, ERs send moms straight up to L&D. You don't even have to wait. (The ER docs don't like to treat pregnant ladies IME and they are happy to send you up to the floor ASAP.) There, if you tell them that you're measuring small and that you're not feeling the baby move as much as you should, they will hook you up to the monitor and most likely give you a Non-Stress Test and a Biophysical Profile. The BPP involves an ultrasound. These two tests are non-invasive and can tell you how your baby is doing in the womb. They can also do a growth scan at that time and tell you if your baby is measuring "on target". We consider IUGR to be less than 10th percentile. You could find this out at that time. Good luck!

[Almi]

One thing that popped into my mind is:  Are you sure you measured your fundal height correctly?  Not that I'm saying you're stupid or anything, it's just something I would probably do because it's something I've never done before.

The next thing is, you keep saying that you don't want to get roped into prenatal care or a birth that you don't want.  However, it is always your choice, and all you have to do is choose not to go to the hospital for any of these things!  Once you are there you never know what they'll coerce you into, but no one can force you to go there.  In fact, at the hospital where I go for prenatal care, if you don't make an appointment yourself, they won't bother you about it or make one for you or anything.  I actually had an appointment scheduled when I would have been 8 weeks pregnant, but I just chose not to go.  They didn't even call me, I just showed up at my 12 week appointment that I already had scheduled.  Lol.

Anyway, if I were you I'd probably get it checked out and go from there, even if it meant jumping through a few hoops.  Otherwise, don't forget to consult your intuition as well as your baby to see how things are going. :)

[Dineapple]

I think I am measuring correctly, but when he moves and presses against my stomach I measure larger (around 35). So I am stumped and I am going to try calling around in my area tomorrow to pregnancy clinics. I will keep you all posted on the turn-out. 

Does anyone know if a transverse baby will measure smaller? I do feel like he is sideways and posterior. Just the fact that he apparently has so much room to move and change positions constantly makes me think that he may be pretty small. I am also pretty small myself, I started the pregnancy at 110 and have gained 35 lbs, (mostly in my rear), and from what I can find on the internet it seems that small girls may just measure smaller. Hopefully it is a combination of different things and all will be well :)

[cameragirl]

Yes, from what I've read a transverse lie can make fundal heights smaller than normal. Your uterus will seem wider than tall, and you can feel the fetal pole on the sides. I'll link to the article I read from Midwifery Today below. I'd also check out Spinning Babies and see a chiropractor trained in the Webster technique and pregnancy care if you can. Chiropractors are usually very into natural health care and birth, and they won't pressure you into any interventions unless it is truly needed. They have a pretty good success rate at turning babies.


Transverse lie:

http://www.midwiferytoday.com/enews/enews0304.asp

[MiaFL]

Where in FL are you located?  Maybe if you posted in Find Your Tribe someone could suggest some care providers.  You're right, FL is not a VBAC friendly state, but I know there a few who do it in my area and I bet there's someone in your area who could help you out. 

[scottishmommy]

You need to see an ob or a midwife. If your baby is transverse this late there is a risk of cord prolapse if your water breaks. If your baby is in fact measuring 6 weeks behind, he or she may be very sick. Of course everything could be fine, but you won't know unless you get checked out.

[scottishmommy]

You need to see an ob or a midwife. If your baby is transverse this late there is a risk of cord prolapse if your water breaks. If your baby is in fact measuring 6 weeks behind, he or she may be very sick. Of course everything could be fine, but you won't know unless you get checked out.

[hildare]

your post worries me.  i honestly think that you should seek some care at this point to find out what's happening.  and, as you know, if you do find out everything is fine, you can still birth however you choose.  no one is going to tie you down and force you to have a c-birth. 

why can't you go back to the midwife you were originally seeing-- how far is it, too far to go back for a visit?  and, what are you planning to do if the babe is still transverse?  you can't birth a transverse baby vaginally.

eta:  i really believe people should get to birth however they choose, but i feel compelled to suggest to you that you do have concerns, and possible risks and that you might be avoiding medical care because you don't want to lose your "ideal" birth.  it's still up to you, but to me it sounds like you're putting yourself in a very dangerous position for you and your baby.  you can get medical care to find out what's going on and make an informed birthing decision too-- those things are not mutually exclusive.

[hildare]

Originally Posted by MotheringBliss 

Preeclampsia can be handled through diet/supplementation...http://www.bastyrcenter.org/content/view/612/

                                 http://www.blueribbonbaby.org

the first article says that you can attempt to PREVENT pre-e with diet.  there is not a treatment of pre-eclampsia, other than having the baby. 

sometimes if it is mild, you can have bedrest but severe pre-e can cause oxygen deprivation for your baby and seizures and many other scary and life-threatening problems. 

it's a great idea to monitor your diet to try to get blood pressure under control, or to prevent a condition; however, you cannot treat pre-e with diet modification. 

[Dineapple]

OK, so I went and got an ultrasound today and the baby is doing well. They were very surprised by how much baby I had in there and estimated him at 6 lbs 11 oz. He is head down, (I felt like he had turned the night before last), and his FHTs were good, (149). The only concern is that my fluid is low. So, my options seem to be to stay home and stay super hydrated or to go to an OB and most likely be sectioned. I am going to do some more research on this right now, but please feel free to leave your input. 

I am sorry that this post has caused a few people concern, and Hildare is partially correct in thinking that I may not be acting in the baby's best interest by trying to protect my 'perfect birth'. I do really believe that if all is well that my baby and I will both benefit from a family centered homebirth, but I in no way want to put either of us in harms way, so it has been a complicated process trying to balance all of it. I got VERY lucky in that I happened to meet a friend of my mom's who is an ultrasound tech and offered to scan me, otherwise I really feel like it would have been a hospital visit that ended in a possibly unneccesary c-section. Thanks to her though I am able to be home right now trying to make the right decision for me.

As for diet not effecting pre-E once you already have it, I have been told by my past midwife group and read a few articles on how diet can possibly reverse, or at least control mild pre-E. I do believe that prevention is the very best "cure" however :)

Thank you so much for your support and all of the helpful information, and I really appreciate that even the criticisms were offered constructively and respectfully. I will keep you updated on how things go!

[DaisyO]

I would opt for the hospital birth, even if that meant a certain c-section.  I agree with Hildare that a perfect birth is not worth it if the baby is harmed by the birth.  Low fluid can cause cord compression during a vaginal birth, which would be a very frightening emergency if you were at home and unattended. 

I think UC can be fine if the signs point to everything being totally normal.  This sounds too risky, with the fluctuating blood pressure, constantly flipping baby (which can also lead to cord problems) and low fluid.  He needs as much oxygen as he can get during the difficult process of being born.  I'm sure you will love your little baby just as much if you have a c-section as if you had a "perfect" homebirth...I can tell you already love him a lot to want to give him a peaceful, non-medicalized entry into the world.  You want him to be healthy so you can love him without regrets, and maybe that means a c-section for this particular baby.

I don't want to come off as judgmental, I'm sure you are a wonderful caring mother, but this situation just makes me VERY concerned for you and your little baby.  The end goal should be a healthy happy little baby, I believe.

Edited by DaisyO - 11/2/11 at 4:30pm

[PollyC]

Originally Posted by DaisyO 

I would opt for the hospital birth, even if that meant a certain c-section.  I agree with Hildare that a perfect birth is not worth it if the baby is harmed by the birth.  Low fluid can cause cord compression during a vaginal birth, which would be a very frightening emergency if you were at home and unattended. 

I think UC can be fine if the signs point to everything being totally normal.  This sounds too risky, with the fluctuating blood pressure, constantly flipping baby (which can also lead to cord problems) and low fluid.  He needs as much oxygen as he can get during the difficult process of being born.  I'm sure you will love your little baby just as much if you have a c-section as if you had a "perfect" homebirth...I can tell you already love him a lot to want to give him a peaceful, non-medicalized entry into the world.  You want him to be healthy so you can love him without regrets, and maybe that means a c-section for this particular baby.

I don't want to come off as judgmental, I'm sure you are a wonderful caring mother, but this situation just makes me VERY concerned for you and your little baby.  The end goal should be a healthy happy little baby, I believe.

 DaisyO, and the others whove commented above,

have you considered that the original post might be fake, like from a troll?  not many women woudl be actively going for a VBAC UC if they had possible preeclampsia, possible IUGR, low fluid, a baby with an unstable lie (w/ low am. fluid?!), and weren't familiar with the local medical community at 38 wks.  just doesn't seem like a real option...but it does seem like a narrative that casts UC in a bad light, and from a brand new member (not that I have lots of posts lol).  As you might know from here and elsewhere UC is kind of, sort of, under attack from elsewhere.  there was even soemthing here a little while ago that seemed to be from a troll out fishing.

Dineapple, please accept my heartiest apologies if I'm wrong, and know that I have compassion for you and your baby.  but also please accept my recommendation to find an OB right away.  you want your LO to live more than you want a great UC experience

I just had to write this b/c the whole thing seems so farfetched.

[Buzzbuzz]

I do have to agree with the others that it is time to visit an OB post-haste.

Because I just can't let it stand -- as far as I am aware there is absolutely no reliable scientific evidence that various diets are helpful with pre-e.  In fact, many of the diets suggested may be actually harmful to certain organs due to the large amount of protein recommended. 

I know those of the natural persuasion seem to find tremendous comfort in the thought that if they just eat enough kale (or whatever the item du jour is) that they won't have cancer or heart disease or whatever.  Its very nice to think that all those sick people aren't like you and that you're morally superior to them due to good eating habits but I assure you, that belief is a load of BS.  Good nutrition is a helpful foundation, but it is not the be-all and end all.

[Dineapple]

No, I am not a 'troll' 

Anyways- I went in for another ultrasound last night and my fluid had dropped even more, so I went to the hospital fully expecting to be sectioned. Long story short I was treated like an idiot and they refused to do an ultrasound to confirm low fluid because the baby looked fine on the monitor and my blood and urine all checked out fine. Hospital policy- the doctor wouldn't even come in to talk to me. I do have good insurance so that wasn't the issue. They wouldn't accept that I had been measuring small because I had done the measuring myself and they wouldn't measure me either. The doctor that decided to go home instead of checking on me generously offered to accept me as a patient at his practice if I called his office on Monday with all of my prenatal records. The nurse told me my only real option was to wait to go into labor and then come back to the hospital to "be cut", because no one would vbac me. 

Thankfully, the baby is still doing well and doesn't seem to be in any distress, but I found their advice to come back if I hadn't felt the baby move in an entire day alarming. Just do an ultrasound! Jeez.

 All of this at the 'best' maternity hospital in a very hospital saturated area,and when we called around this policy was standard at the other 8 hospitals in the area. 

 So I am at home, frustrated and wondering what to do. Trying to rest and stay hydrated, but beyond that I am at a loss.

Also my bp was at 137/96 which is higher than it's ever gotten at home and they weren't worried about it, I do think it was that high because of stress though.