Unreassuring second beta. - Mothering Forums

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#1 of 18 Old 03-09-2008, 04:06 PM - Thread Starter
 
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The midwife called me today to let me know that my hcg level from my second blood draw was 236. She said that this was not a good pregnancy level and that she's concerned. She thinks my levels should be in the thousands or tens of thousands right now.

First level at 15 dpo = 130
Second level at 17 dpo = 236
Draws were 45 hours apart rather than a full 48.

I've just spent the last 2 hours crying with my husband. He's absolutely devastated. I still have some hope.

I'm no longer spotting (and only ever spotted a tiny bit). My temperature was still almost a full degree over my coverline this morning. My breasts hurt. I'm queasy. I feel pregnant and I really believe in this one. I don't think I'm being delusional and I don't think that I'm clinging desperately to false hope. I really, really think that everything might be okay.

Still, I can't stop crying as I type this. I'm trying to look up everything I can about low doubling times online, but any reassurances or experiences you have for me would be very much appreciated.

Elated mom to Elliott (5/25/10)
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#2 of 18 Old 03-09-2008, 05:07 PM
 
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I really hope everything turns out okay hon! *hugs*

Jamie 24 yr old mama to K Paige 6, Chloah Liz 4, homebirth Addison Elliot 1 (11.17.08) proud aunt to Marley Colt (2.11.08):::
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#3 of 18 Old 03-09-2008, 05:41 PM
 
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The numbers are still going up which is a great sign. That isn't far from being double. I've always heard that the numbers should double every 2-3 days.
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#4 of 18 Old 03-09-2008, 07:28 PM
 
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((hugs)) I would be hopeful because they're very close to doubling.. and if she tested your blood before the 48 hour time limit then of course they're not quite doubled yet. Don't throw in the towel yet!

Wife, Mother and Doula.
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#5 of 18 Old 03-09-2008, 07:49 PM
 
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Popping in from the September DDC.

At this point in pregnancy, HCG should double every 2 to 3 days. My first beta was drawn 16 DPO and was 47. Two days later my second draw was 78 so I went in for a third which was 176. Now I'm 11 weeks along!

This beta stuff can be pretty stressful but I think your numbers have a lot of promise.

Mama to Blake, 5, and Grant, 3
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#6 of 18 Old 03-09-2008, 09:31 PM
 
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Try not to stress too much. Thinking good thoughts for you.

Mama to 3 kids. We live in a yurt!
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#7 of 18 Old 03-09-2008, 10:19 PM - Thread Starter
 
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Thank you all very much for your support. The more I think about it, the more I'm disinclined to trust this midwife. I had already decided that she wouldn't by my care provider for the birth--I'm moving in a few months and will be working with someone else.

My husband and I spent hours crying earlier and I'm feeling like a lot of that was unnecessary. I'm *hoping* that a lot of that was unnecessary. The idea that I should've been "in the thousands or tens of thousands" when I was only 17 dpo yesterday seems extreme. This site says that the average for 17 dpo is only 132 (I'm not a big babyzone fan, but whatever). This one gives the same basic figures I've found elsewhere, suggesting that the normal range for 4 weeks is 5 - 426 mIU/ml & for 5 weeks is 18 - 7,340 mIU/ml. Might've been in the thousands, sure. Should've been in the thousands or tens of thousands? No.

I'm getting my third level drawn as planned tomorrow. Am wondering about getting a different local midwife for the interim between now & when I move back to NY or if I should just skip it because I'm planning on traveling to my NY midwife for prenatals anyway.

Elated mom to Elliott (5/25/10)
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#8 of 18 Old 03-09-2008, 10:45 PM
 
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I also disagree with the midwife - thousands or tens of thousands at 17dpo?? No way! Absolutely not.

Does she know how far along you are?

I also like this site - they also have a doubling calculator which put your doubling time at just over 51 hours. Well within the normal range of 48-72
Shoot, it's not letting me enter a link. Here - http://betabase.info/showBasicChart.php?type=Single

mama to two sweet girls love.gif 8/05, fairy.gif 11/08, a handsome little guy babyboy.gif 4/11, and expecting another 5/13
always missing our angel1.gif (11/04, 4/07, 8/07, 5/10)
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#9 of 18 Old 03-09-2008, 10:48 PM
 
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I hope everything is more reassuring after your next draw tomorrow and you find a midwife in your new town who knows what she's talking about.
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#10 of 18 Old 03-10-2008, 12:16 AM - Thread Starter
 
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She does know how far along I am, but she keeps saying 6 weeks rather than 4. I've corrected her a few times and then she says that I still seem low for 4. I printed out a copy of my chart and annotated relevant parts. I'll bring it with me tomorrow when I see her to get the lab orders, but I'm not sure that I'll have enough time to sit down and speak with her.

I think that I've found the midwife that I want to work with once I move back to Brooklyn. I interviewed her by phone on Wednesday and have since contacted her twice more once for a second opinion once the local midwife started giving me really negative assessments. The NYC midwife would also like to see my levels be a little higher but is much, much, much more reasonable than the local midwife. She just sent me a long, considerate email to essentially say that this is a wait-and-see issue rather than a truly negative result. I appreciate that she isn't trying to give me unqualified hope but instead is affirming my body's ability to do what is best and is telling me that early tests like these really can't tell us much at all.

I am now considering having an early ultrasound. I had planned to avoid that, but after I've spent so much time being upset and worrying this weekend (and after having absolutely crushed my husband by proxy), I'm wondering if the confirmation/reassurance might be a good idea. I'm also thinking, though, that I want to wait long enough for an early ultrasound to be quite sure that I'd see a heartbeat rather than being told to come back in a few days and check again.

Elated mom to Elliott (5/25/10)
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#11 of 18 Old 03-10-2008, 12:27 PM
 
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just lurking from May DDC...

The minimum they like to see is 66% increase in 48 hours. Yours is 82% which is well above there. It is also in a very good range (over 100 at 14/15 dpo) and not low at all. Given it was a few hours shy, it may well have been exactly doubled had it been given time.

If you do choose an u/s, I would wait till the 7th week if possible. That's going to give you the best likelyhood of seeing a heartbeat and getting some reassurance.
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#12 of 18 Old 03-10-2008, 11:25 PM - Thread Starter
 
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I voiced my frustrations and reservations to the midwife today. She initially balked and started to criticize me for not being fair to her, but once I started crying she pulled me into an exam room to talk further.

She continues to be concerned about the lowness of my levels but admitted that she is very hopeful for me. She had not said that before now, so hearing that she hasn't given up on my pregnancy helped. She wanted to schedule a vaginal exam for this week but I point-blank refused and she ultimately said that she accepts that. I also said that I am not willing to have an office visit with her until next week. She originally wanted for me to come in on Wednesday evening, which is my 1-year wedding anniversary (sort of--long story). So I'm going to wait to hear what today's level is and will go in to see her next week, but I might not follow up with her beyond that.

I had a third level drawn and am hopeful. I really, really feel like my levels seem within normal range for where I am. I'm just barely pregnant.

If my levels were dropping, or remaining stable, or MUCH lower than they currently are, then I would be much more concerned. As it is, I am concerned and I do care a lot. I just refuse to panic in the absence of any strong reason to. The only thing that I can do for the benefit of my embryo right now is to avoid stress. Worrying isn't going to help matters and I feel like it's unconscienable for her to emphasize that my levels are discouraging when I've found numerous resources, both peer-reviewed and geared for the general public, that (a) put my levels and my doubling times within normal range and (b) state that early pregnancy hcg levels and doubling times show wide variability and aren't hard-and-fast predictors of likely outcomes.

Elated mom to Elliott (5/25/10)
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#13 of 18 Old 03-11-2008, 09:57 AM
 
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Hugs to you mama! I hope those levels are nice and high for you! Your MW leaves a lot to be desired. At least you have the option and are able to find someone else

~Natalie~
LLL Leader, IBCLC, marathoner, mom of 2 (maybe 3 one day!)

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#14 of 18 Old 03-11-2008, 10:17 AM
 
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Hoping that you hear good news from your MW today!

Being hopeful can only help for now . . .and I would absolutely wait until the end of week 6 at the earliest for an u/s. we were bale to see the HB earlier, but you want to be absolutely sure that you don't leave any room for the "come back in 1 week to be sure" u/s appointment.
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#15 of 18 Old 03-11-2008, 10:53 AM
 
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Wow! As if we don't worry enough in the first place, this midwife sounds very stressful to deal with. Just go with your gut, luckily you'll be moving soon!

P.S. I used to live in Brooklyn as well. Boerum Hill, Crown Heights and then Park Slope!

SAHM to DS (11/08) and EDD 3/8/11!
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#16 of 18 Old 03-11-2008, 10:59 AM
 
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Another Brooklyn mama! I'm feeling hopeful for you Glad you found a good midwife here - we hve tons of fantastic options!

Megan Davidson, Labor & Postpartum Doula, Breastfeeding Counselor, Anthropologist, Mom to August (9) and Clay (4), Partner to Shawn.

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#17 of 18 Old 03-11-2008, 11:17 AM - Thread Starter
 
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Thanks for the support. I posted my update as a new thread but perhaps I should have aggregated it here. Part of me feels really hopeful right now and part of me wants to curl up into a ball and cry because I'm so frustrated with this midwife.

Elated mom to Elliott (5/25/10)
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#18 of 18 Old 03-11-2008, 11:55 AM
 
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I don't understand why she's freaking out *at all*! According to the American Pregnancy Association, you are completely and totally in normal range. You shouldn't be in the "thousands or tens of thousands" until 6 weeks. She needs to go study!

Jesus-loving wife to my best friend and love of my life , mama to my boys and and our little one, who was blessed enough to go straight into the arms of God (11/09)
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