Thalia's fertility journey: hopefully more comedy than tragedy

Bits and pieces of hope

Some interesting articles relating to infertility recently. Here's a digest:

1. Potential for a new kind of pain relief - aromatase inhibitors (those currently used in treating breast cancer) have been shown to be very effective for relief from endometriosis-related pain.

2. PGS does not improve pregnancy rates, or reduce miscarriage rates. The British Fertility Society strongly recommends it is not offered to women unless as part of a defined clinical trial. I think we kinda knew this one - I've certainly seen comments to this effect, but important if your doctor is currently suggesting it.

3. Australian scientists are engaged in a long range study to look at what genes are expressed in blastocysts, and how these vary between blastocysts which turn into live take-home babies, and blastocysts which fail to implant or to turn into embryos which survive through the pregnancy. Very interesting story, which has already identified (no shit Sherlock) that genes involved in cell adhesion, cell communication, and response to stimuli, are all involved. They've also found that up to 20 cells can be removed from the cell lining layer of a blastocyst with no adverse effects. They are aiming to promote single embryo transfer - but arguing that for this to be widely accepted, couples need to have greater faith that SET is likely to work. What I don't quite get is how to transfer this to the clinic setting, as you would presumably have to do the gene amplification within a day so that you could put the blasts back before they start trying to implant. Or perhaps they plan to work backwards so that you could take a cell from a day 3 embryo and test it against their findings.

4. In the realm of "Thalia feels very smug," a finding that many doctors are moving away from ever recommending IUI, and going straight to IVF, which in the long run is often cheaper and less traumatic for couples as it's more likely to work. I've always thought IUI is a waste of time, given how little it improves your chances over trying alone, even with the addition of clomid and/or injectibles. It's also more likely to lead to higher order multiples in the hands of over-eager docs in the US, so a good thing if it's on the decline. Old-fashioned technology.

5. Data that says that IVM may not be the way to go in many instances. Eggs matured in the petri dish have a different pattern of development than those matured in vivo. Which also means that labs should be working to develop culture media that better replicate the ovarian environment.

6. Feed your male partner folic acid. It reduces the level of DNA abnormalities in sperm.

We're back on

This used to be an infertility blog, right? Anyone ready for a return to the regularly scheduled freak-outs that that topic encourages? Yes? No? Well, it's coming anyway.

I seem to have neglected to blog about our visit to Dr Candour when Pob was about five and a half months old. He told us not to stop breastfeeding in order to get pregnant - that a few months would not make a big difference, and no one ever wished they'd breastfed for less time. He considered that we had a good chance at number two, given that I've responded fine on three IVF cycles, we have a few embryos frozen (I think about 6 although some are crappy looking), and Pob is the evidence that there are good eggs in there somewhere. He ordered an hsg and a scan for when my periods had returned, and we went away happy.

I've now had three periods since I stopped breastfeeding. Each time I've had clear signs of ovulation, we've made the most of that opportunity, and my period has sadly showed up 12-13 days later. I'm back on my usual schedule. I had the hsg and the scan during my last cycle, and both were fine. The scan even showed a very healthy set of antral follicles - at least 5 on each ovary - which delighted me.

We reviewed those results with Dr Candour yesterday, and agreed that the next step was a fresh IVF cycle, starting with my next period. It all seems a bit sudden to me. And oddly enough, while I have hope each month we try that I'll get pregnant again spontaneously, I'm not that hopeful about an IVF cycle. Dr Candour says their stats for women my age are 22% for an IVF cycle, whereas the chance for trying naturally is certainly no higher than 10%, if that, so, in his words, "IVF is a lot more efficient in a specific month than trying on your own." He recommends trying a fresh cycle, partly to see what my ovaries are capable of, and partly to keep those frozen embryos in reserve, given that they aren't getting any older, while my ovaries clearly are. He also recommends trying as soon as possible, because at this point, months probably do count.

This was the same conclusion H and I had come to before we showed up in his office, but I left the meeting yesterday feeling just matter-of-fact - this is something we have to try, not something that I put a lot of hope in. Which is correct, because 22% isn't that good a statistic, no? And let's face it, IVF hasn't exactly been the golden ticket for us previously.

So I've got the prescription, and we've got the consent forms, and H is off to do a sperm test early next week. I really really want another baby. I have hope that there is a possibility we might have one, not a lot of hope, but some. I'm just not sure that IVF will get us there. But it's worth a try.

Pob's head

Cranial osteopathy. It's not science, it's not medicine, but it changed my cousin's son utterly. At two months he wasn't meeting his developmental milestones. He was floppy and didn't interact much with the world at all. At three months, after a few sessions of cranial ostepathy, he was a different child. Now he's 6 and is just a great, normally rambunctious, little boy. So when Pob started to scream at the breast at about 6 days old, my cousin suggested I take her to a cranial osteopath to see if it might help. Despite my scepticism, I figured, 'can't hurt, might help' and took her at 13 days old for her first appointment. She visibly relaxed and lengthened during that session but the few feeds immediately afterwards were the worst we'd had, so I didn't take her back until she was around 11 weeks old when yet another lactation consultant suggested it might be worth a try.

At that visit the osteopath apologised for not warning me that things might get worse before they got better. Again, Pob seemed to really chill out during the session and so I decided to take her back again this week. At this session, the osteopath pointed out that the right side of her head was getting a bit flatter than the left. I'd already noticed that she favours turning her head to the right, and have been trying to encourage her to turn the other way as well, but not very systematically. I've tried putting her cot book to the left, putting a mobile on that side of the crib, etc. The osteopath said that her neck is pretty stiff so he did some work on that, and suggested we keep trying to offer her toys, etc. from that side to encourage her to even things out. I'll also take her back to see him in a few weeks time.

I know many of you have had helmets for your children when a problem like this has showed up, usually when they are a bit older, though. Both the osteopath and the paediatrician who saw her when she was born told me that British children tend not to get helmets unless the imbalances are REALLY severe, as it's thought better to correct the root cause of the imbalance rather than the outcome. In Pob's case, it seems to be some neck stiffness, so we'll work on that with the osteopath and see what happens. I'm not worried, but glad to be aware that we should do some work on this. H is worried, and has immediately put Pob on left side boot camp, changing the way he gives bottles, only talking to her from that side, etc. It's quite amusing, he can't bear his perfect daughter to have anything not perfect about her. I'm happy to wait and see what effect bootcamp has before we worry any further.

Two months

Yesterday, Pob was 2 months old. She is suddenly much bigger, much more of a little person. She smiles a lot, particularly at me, but has also started to smile without us smiling at her first, which is apparently one of those milestones. I even got a little giggle out of her a few days ago by making repeated "ooo, ooo" noises at her, although she hasn't repeated this trick. If I come into the room and start talking while she's with someone else, she'll turn her head to try and find me. She can't quite get her head to a 45 degree angle when she lies on her tummy, although she can raise it enough to turn it from side to side. Which we encourage since when she's on her back she has a strong preference to look to the right so H is worried she'll develop a flat head.

She is gradually losing all that dark hair she was born with, but still has enough that she doesn't have that total baby bald head. Her eyes seem to be darkening, but still have a bit of blue in them so I haven't yet lost hope that she will have dark blue or green eyes rather than the dominant brown from my side of the family. her skin is quite pink and white, but with yellow undertones such that she looks best in pale pink, much to the chagrin of her father who'd rather she didn't look quite so girly. I am so enjoying dressing her in the multiple adorable outfits that we've been given, although she HATES being changed so I'm limited to one cute outfit and one sleep suit per 24-hour period, unless she does one of her exploding poos, in which case she gets one more chance at the chic.

She is quite the little angel other than the feeding issue. She plays happily on her mat, or sits in her chair and watches what's happening for up to an hour after a feed. She tells us she's tired by yawning and rubbing her eyes. We swaddle her and put her in her moses basket, and she goes to sleep after a few minutes of chatting or grumbling to herself. She wakes up starving hungry, unless I wake her first, which I often do, just to get her to eat that bit more.

We have fallen into a vague kind of schedule, which I need to make the most of by getting up and doing the breakfast time feed slightly earlier. It's just that she wakes for a feed around 0430, which we finish (after breastfeeding, bottle and pumping) at around 6. By the time I've fallen asleep again it's 630 and when she starts to stir at 8 I'm really struggling to open my eyes, so I often let her fall back to sleep for up to an hour. Which then means by the time we've done a feed every 3-3.5 hours during the day, I'm doing the last feed at 2230, which finishes at 0000, which means I only really get 4 hours of sleep, and 2 hours of a nap each night. I know I should count my lucky stars that I have a baby who sleeps, and I promise you I pour libations to the fates every day for this part of her personality, what I'm bemoaning is my inability to sit up and feed her at 8am which would probably get us into a better rhythm all round. The schedule is allowing me to get the 2 of us out for a walk every day, but not to do much else, thank-you notes be damned.

  The feeding has got a lot easier. Not in that she's better on the breast, she's the same, but I've stopped minding quite as much. I was quite hysterical there for a while. Now I've figured out how to give her a bottle while I pump, we have quite a reasonable rhythm of breast (both sides), followed by bottle and pump. The whole thing takes just over 90 minutes (including nappy changes, burping etc.), depending on how long I put her on the breast for. She'll happily stay there for hours, falling asleep then waking up and sucking again, but after a while I worry about her getting hungry so we stop and go for the bottle. I'm pumping enough to give her breast milk in her bottle for 4 out of six feeds, and she gets formula in the other 2. I'm not horribly upset by this any more, the stuff isn't toxic, it's the loss of the breastfeeding relationship I wanted that I had to mourn, this fantasy of me nourishing my child in a very earth-mothery type way. Well, I am nurturing her, just not in the way I'd intended and heaven knows I couldn't do more than I have done. I guess some people could do more, but pumping six times a day now is as much as I can do without feeling really angry and tired, so that's what I'm doing.

We had her 6 week check up and jabs today. Yes, I know she's 9 weeks but that's the NHS for you. She's now 10lb2oz and back on the 25th centile for weight, while her head and her height are on the 50th centiles. So that's a relief. The jab experience was moderately traumatic for both of us - she screamed blue murder while I had tears in my eyes. After the initial scream, she abruptly went quiet and looked me in the eye, and I swear had such a look on her face - very much "Mummy how could you do this to me when I trusted you." Absolutely terrifying!

So we're doing well. I don't know how much longer I will pump as it's such a time sink, but for now I'm ok with it and I feel good about the amount of breast milk she's getting. I'm really enjoying her, relishing the little personality which is emerging. And feeling very very lucky, every day.

 

Oh well then

Today was a series of small pieces of data, woven into an answer by a very impressive woman OB/GYN. Once we'd heard the story,there was no other answer but that this baby will be born by c-section. But it took a while to get there.

Part 1: the scan
The consultant sonography doctor confirmed that the baby was breach, with her spine down my right side. Her head was a little higher than I've been feeling her recently, which I wasn't surprised about since she tends to move up at night, and sink gradually down the right side as the day goes on. He, again, did not see the fibroid that the two women sonographers I've seen during the pregnancy have noticed, measured and commented on, the one down by my cervix (note - signalling!). I wonder if this is perhaps he doesn't want to go digging down into my pubic bone, which is what it takes to visualise that fibroid. The good news was that everything looked good with the baby. Her growth is on track, the level of amniotic fluid looked good, and he even pointed out she has quite a bit of hair - on the ultrasound it looked like feathery extensions of her head into the fluid!

Part 2: Dr OB
We saw Dr OB briefly for a urine and blood pressure check (110/70, still good). He then directed us to go and see Dr big picture, who would review our notes, scan etc., and help us make a decision about whether or not she would attepmt an external version. I confessed I didn't hold out much hope it would work, since this baby has been in a very consistent position for over 6 weeks now, and he confessed he felt the same, but thought we'd all regret at least not giving it a try. So back we went to the other bit of the hospital to see Dr big picture.

Part 3: Waiting
Before Dr Big Picture could see us, we needed to have the baby's well being assessed. So I got strapped into a fetal monitor device in the day care unit, to measure her heartbeat. She was not Miss cooperative, and kept moving position after the monitor was placed on my stomach. After a while we found a position where mostly the monitor could pick up her heartbeat, but even so about every 2-3 mintues an alarm would go off as the machine stopped hearing her, and I'd have to reset it. She also got hiccups, which was quite entertaining. The heartbeat varied between 165ish and 120ish, mostly around 140 which is what I've measured with the home doppler pretty much throughout the pregnancy.

After about 20 minutes they took pity on me, agreed she was clearly very healthy and extremely wriggly, and took the monitor off. However, it then turned out that Dr Big Picture had been called into an emergency, so we'd have to wait. So we waited. For quite a long time. About an hour and a half maybe? Pob kept making quite major movements, waves of baby moving under the skin of my stomach, as if to indicate her displeasure at all this messing around. She succeeded in getting into a position which actually just hurt me, so I was getting quite grumpy. Not about the wait - an emergency is an emergency - but just about being uncomfortable.

Part 4: The answer
Dr Big Picture eventually showed up and was terribly apologetic about the wait. She took us back to an exam room, and started going through the file. She read this morning's report first, then flicked through my maternity notes. And said "ah, fibroids. When Dr OB told me about you last week, he didn't mention fibroids." (Note: more foreshadowing!!). She then started reading through the other ultrasound reports - the ones from 27 weeks and 32 weeks where the fibroid was carefully measured and commented on. She got me to tell her about the laps and hysteroscopies, and reviewed the pictures from those operations. She felt where Pob was and commented that really Pob was oblique and not breach - her head having moved down at least 10 cm since the scan in the early morning.

After some discussion, Dr Big Picture decided to scan to see for herself what the story was, and went straight to the fibroid. It's about 6x5cm and it's adjacent to the cervix, right in the pelvis. She showed us that none of the baby is down by the cervix, she's all up in the abdominal cavity. She told us how babies just don't choose to be oblique, there is almost always a reason for them staying in that position, and fibroids are the usual culprit. She sketched out very clearly what the situation is. The fibroid has taken up some of the space in the pelvis where Pob's head should have gone. Pob has probably tried to get round (that certainly makes sense given the seismic level of movement I've felt over the last few weeks) but hasn't had enough purchase to do so. In addition, the fact that none of her has been down near the cervix means that that part of the uterus hasn't stretched to accommodate her, so if we try to turn her now, she'd most likely pop back as there isn't enough space for her.

Yup, you got it. Not even worth a try.

Part 5: The conclusion
We went back to Dr OB to update him and book our c-section date. 20th September, at about lunchtime. So Kath and I will have daughters just a day apart. Not quite sure what I'll do about Yom Kippur, which starts on the Friday night, but I think I'll be forgiven in the grand scheme of things. Pob needs the extra time so her lungs can be ready to breathe.

It was good to have a clear opinion, and to really understand why we're where we are. But I really really feel disappointed. Odd, I know, given the ambivalence I started off with about a vaginal birth.  But hearing from you and others about the amazingness of being able to have your body push out that baby, well, it made me want to be part of it. I am not devastated, I recognise 100% that once we have Pob in our arms, it won't matter (that much) how she got here. I also recognise it's the only sensible option at this stage. It's a very small loss in the grand scheme of losses we've been through. But I am sad that I won't get to do it in the old-fashioned way. Also, I find it a bit odd to know in advance what Pob's birthday will be. I feel like she should have some say in this. Odd, I know, but there you go, just one of my many irrational feelings.

This time, two weeks from now, we'll probably, hopefully, be holding our daughter.

Coffee, nectar of the gods

A long time ago, when we first started trying to have a baby, I gave up coffee. It nearly killed me. I love coffee with a firey passion. I drink it black, and I savour every mouthful. I never drank more than 2, perhaps 2 and a half cups of black coffee a day, and I enjoyed every bit of it. I was quite fussy about what quality of coffee I drank. No instant coffee, no bad meeting-room coffee, no Americanos unless I was absolutely desparate. The only coffee chain in the UK which actually brews coffee rather than giving you an Americano is Starbucks, so that's where I went. At home we drank single-source coffee, from beans roasted the day you order them.

Initially I cut back a little by ordering a half-decaf, half-normal brewed coffee at Starbucks on weekdays. Then Starbucks stopped brewing decaf coffee in the UK so that was out. Around this time a study was published which showed that consuming levels of caffeine above 300mg a day was associated with an increased level of miscarriage. We'd been trying for about 6 months. I wasn't consuming that much coffee, but I figured that if 300mg caused a problem, why was I tempting fate by consuming any coffee at all? So I went cold turkey. I also gave up diet coke, mostly because of the aspartame, but I could not countenance giving up chocolate, so that stayed on the cards. So I was getting some caffeine but not much. I substituted funky teas for coffee, and I missed it, particularly at the weekend when H would brew up a pot of lovely smelling coffee and I'd be there with my cup of green tea.

And then I found out that green tea can reduce absorption of folic acid. Which I'm already prone to be deficient in, given my MTHFR homozygosity, so green tea was out. I switched to the Tazo tea, Calm, but clearly it wasn't the same. No jolt of energy, no lovely complex smell to inhale.

This went on for some time. Gradually I started to feel resentful. I'd had enough of deprivation. Two years of failed cycles and miscarriages made me feel I deserved to eat the things I liked. And given everyone around me seemed to get pregnant happily on a diet of coffee, wine, and rich food, I didn't see why I had to suffer. So the coffee started to sneak in. At first it was just off-IVF cycle, while I was on zoladex anyway, so no chance of conception. And it was half a (small) cup of coffee, at the weekends, at home. And then sometimes on weekdays too, if I wasn't rushing off to work. I still hadn't picked my Starbucks habit back up.

And then we went on holiday to Morocco for my birthday. And we know now that I was already pregnant. And I had wine every evening for dinner, and coffee, plenty of it, for breakfast. And somehow, not that miraculously, this embryo hung on despite me creating what Zita West would term a 'toxic uterus' for it. Given this, even once I knew I was pregnant, it was hard to justify being that abstemious again. Of course I stopped drinking alcohol again. To be honest, I can take or leave alcohol anyway, so that hasn't been too much of a hardship. I've allowed myself a few sips of H's wine at dinner, and that's been mostly ok. But the coffee? No, that's a different story. I stuck to the 'coffee at weekends' rule for a while. And then I had a less busy period at work so I was able to have a bit of coffee at home on weekdays. And that turned into most weekdays. The passenger was thriving anyway. I kept going, limiting myself to only drinking coffee from our home brewing, not buying it elsewhere.

Until last week. Last week was very very busy at work. I had to work til 10 a couple of nights (normal in my job, but not normal for me recently). By Thursday morning I felt really really rough. So I went to Starbucks. And I ordered a tall black coffee. Which I drank about 3/4 of. Oh baby, forgive me. But it was good. I haven't been back. But I worry I've now crossed the Rubicon and I'll find another day when I need that weekday cup of Starbucks. And there won't be an obvious reason to resist.

Anyone got any suggestions for how to wean babies off their caffeine addiction?

You know all that debate we had about vaginal birth versus C-section?

I have two baby updates to do. This is going to be a pretty happy clappy post, so if you are not in the mood I totally understand. Also, there are pictures at the end. I've made them small enough I think you'll have to click on them to see them, but just so you know before you get there.

Last Thursday we had a regular check-in with Dr OB. Blood pressure is 110/65 so that's all going well, no protein etc. in the urine. He couldn't be sure of the baby's position but thought she might be breach again. He did, for the first time, measure my fundal height with a tape measure - usually he just uses his hands. He commented that I seemed to be a bit ahead for dates, and that we should check to see if the baby was measuring big and if so, perhaps repeat the gestational diabetes test. I had booked a scan for Monday at our favourite clinic, where we did the 12 week and 20 week scans, so that was just something to put on the list for them. I do wonder about this fundal height thing. I have a bit of belly fat at the bottom of my bump, doesn't that distort the measurement? If he's never measured it before how does he know what's me and what's baby growth?

He also repeated the induction conversation, and it became clearer that they really won't let me go much beyond 39 weeks. He said they'll take it on a week by week basis - if I come in at 38 weeks and the head is engaged and the cervix feels soft, it's time to induce. If the head is still high and the cervix closed, well then they may wait a bit longer. We'll see. We left feeling quite calm and optimistic for a change!

Yesterday's scan was quite miraculous. The first thing that happened was that the sonographer exclaimed how the baby was in a great position for a 3D picture. Before we knew what was happening, there was the passenger's face in front of us. Just the most extraordinarily wonderful thing. She looks like a person! We got two great shots of her, which are below. She was busy yawning and swallowing. It's always utterly miraculous to see her swimming around in there at every scan (and, gulp, she's been scanned 11 times so far in this pregnancy. Please no one tell me scans are bad for them), but to see her in 3D is a whole 'nother level of miracle. I don't know who she looks like, it doesn't seem to be much like me, but she looks amazing. And real - so real!

The rest of the scan went well. She is pretty much average size for this stage of pregnancy, slightly longer femur, slightly shorter humerus (short arms? No good at tennis, then, H will be disappointed), big on one head measurement, average on another. Perhaps she has a funny-shaped head. She also has a big nose and long mouth (my observation, not the sonographer's measurements!), but I will love her regardless of mishapen heads and funny noses.

The only bad news from the scan is that yes, she is breach again. I personally have no faith she will turn given she's been in this position at every scan bar one of this pregnancy, although everyone says it's possible. if she doesn't turn, the whole induction thing becomes moot and we'll have to schedule a c-section. Which, despite me writing ambivalently about birth earlier in the pregnancy, I really don't want. Aurelia really helped me want to give birth vaginally, with her discussion of how wonderful it felt to be able to push those babies out. If I don't get to do that, it will be ok, but it will be a little loss. Not a big one, just a little one. We'll see.

Pictures below, look away if that's the best answer for you.

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This one will stir it all up

This morning a cross-party committee which has been reviewing the government's draft Human Tissue and Embryos bill has reported their findings. Some of these findings support the scientific community - for example, relaxing the ban on hybrid embryos for research. Some are structural or political and I'm not sure are a big deal for patients, such as suggesting that the proposed merger between the HFEA, which regulates fertility treatment, and the Human Tissue Authority, which governs research and the storage and use of human bodies, organs and tissues, does not go ahead.

And then there's the one that I can see a LOT of debate about. And it's the recommendation that donor conceived children have this on their birth certificate.

As you probably know if you read any UK-based in/fertility blogs, last year the government introduced legislation that said that donation of sperm or eggs was only allowed if the donor was prepared to be contacted by any resulting children when they reached 18. That is, the end of anonymous donation. This led to an immediate shortage of sperm donors in UK clinics, which almost matched the extreme shortage of egg donors which has been there for years. The responses to this have included campaigns for donors to come forward, and, I presume although I've not seen any figures, an increase in people going abroad for treatment. My clinic, for example, has no egg donor list, but cooperates with a Spanish clinic which can organise anonymous donors.

If I understand this suggestion, and I haven't read the report itself so I could be wrong, even those who conceived via an anonymous donor in Spain would have to record this information on their child's birth certificate. That's a big change.

The debate about what to tell a child of donated gametes, and what to tell, is a really tough one. Personally, particularly having read the blogs of children and young adults in that situation, plus all the long-received wisdom about adoption and how much better children cope when they know they are adopted as part of their life story (and yes, I am well aware that donor conception is NOT like adoption in many ways), I would want to tell my child. I don't know how I'd tell them or when, given that they'd likely start asking around 2 or 3 and heaven knows how you turn donor conception into an understandable story for a 3-year-old, but I'd want to tell them. For me it would be dishonest otherwise (one of the arguments being made by one of the MPs involved is that NOT putting this information on a birth certificate is tantamount to the state lying to the child), and just setting up the family for later trauma. I don't think it's possible in this day and age that the child would not find out at some point. What happens when they do the genetics part of biology in secondary school and come home to ask mum and dad if they can smell fresias or if they can roll their tongues, or if their ear lobes are attached? What happens when they need a blood transfusion and find out their blood type? There are just too many opportunities for your child to feel you've lied to them. I don't think I'd be able to do it.

Let's be clear, I say think here. I haven't had to be there, so I don't know for sure. But I do think that's what I'd do.

But putting it on a birth certificate I imagine is a huge deal for the parents involved. Birth certificates don't come up at family occasions, as a rule, but it does remove any element of choice from this big, big decision. Is this right? Who should get to make this decision - the tell/not tell decision?

My doctor specialises in being reassuring...

I'm in good shape for 30 weeks (30 weeks!!!). Blood pressure was 110/75, growth is fine (he found the heartbeat of the baby right away this time!), I feel ok apart from the heartburn, ankles have returned to close-to-normal. However, discussing labour today with the doctor he broke the news that they might want to induce me around 38.5-39 weeks. The reason is that in a 'normal' pregnancy the risks to the baby of being born NOW go down until you get to 37 weeks. They then stay flat until about 40w+10, then they start to rise again. However, in women my age and with my history, the flatness doesn't last as long. They aren't sure how long it lasts for, so it's not very scientific, but it is something they worry about. The 2 increased risks are that of pre-eclampsia, which they can monitor for easily, and placental abruption, which they can't and which apparently doesn't always show up as vaginal bleeding. Given his statement last time, that they just won't take any chances with me, it makes sense. BUT I really don't want to be induced, and 38 weeks is really really soon! Certainly puts paid to the idea of working right up to 38 weeks, I know I'll want a bit of time at home to nest etc. before the baby arrives.

If I'm lucky enough to get that time. I went to my ante-natal class today, and one woman had gone into labour this morning, at 32 weeks. She was on terbutaline, so they might be able to stop it, but it was a real wake-up call that (i) we might actually have a baby, and (ii) I might not get the time I want. The doctor's statements just confirmed this.

What they'll do is monitor me carefully. Every 2 weeks from now, then every week from about 35 weeks. They'll decide whether or not to induce based on how I'm feeling, how the baby is growing, any signs of pre-eclampsia or placental abruption, how the cervix is looking, the position of the baby etc. Apparently sometimes they start induction and the cervix just doesn't respond. Sounds like fun, no? Luckily I'm not in any way averse to epidurals as they are more common in induced labour because it comes on so strong when it does start.

I might only have 8 weeks left. It's really quite terrifying. It's not long, and we aren't ready, and I'm realising all the scary things about having a baby. Yes I know it will be wonderful and exciting and the best thing ever, but I do have moments of thinking, as I did this morning when I woke up early and spent a relaxed hour on the sofa, wow, I'll never get to sit here and just simply enjoy this cup of coffee again. There will be someone who needs me. A lot. Almost all the time. That's frightening. And wonderful. And a bit overwhelming. I don't know how it's going to feel, really. But I do know it's going to be more than I can possibly imagine.

All's well

Haemoglobin at 12.6, Blood sugar at 6.3 (sorry I didn't get the units). So I'm not anaemic and I don't have gestational diabetes. According to Dr OB, they don't need to test for GD again within this pregnancy, unless the passenger starts to grow too fast in which case they will look again. So I seem to be in good shape.

H was reflecting last night, as he admired my bump (he is very drawn to it but tends to restrict himself to just stroking it a little when we have a hug, I think he's scared it might bite him or something if he left his hands on it for longer), that it's really been quite a trouble-free pregnancy. And although my initial reaction was "are you kidding??? So the bleed at 13 weeks was just another day in our life???", I think he's right really. Yes, that day was terrifying, and yes, I have been tense on many other days, probably most days, but if you look back on it, other than the embryo being small at 6 weeks, and the bleed, everything else has been ok. The embryo/fetus always looked good from the 7 week scan onwards. All our scans have given us good news. The passenger has no obvious defects. I didn't have substantial nausea. I don't have gestational diabetes. I am not huge and uncomfortable (yet). I'm still sleeping well at night. The passenger kicks me on a regular basis.

I hate to type this as it's one of those gremlin-attracting posts, but I think we've been very lucky. Very lucky to conceive spontaneously given my age and my endo. Very lucky to have a healthy passenger (so far) given my age and what we've been through. Lucky I haven't been made ill by the pregnancy. Very lucky indeed. And today I feel lucky. And happy. And excited.