Hotel Antepartum

Well, looks like this is home, for now. 

I saw my OB this morning and he said he decided not to do an internal until later this week. He does not want to disturb anything in there and since there really have been no physical changes or signs warranting "checking" my cervix, there simply isn't the need. In his words, we are day-to-day...but he is optimistic.

And he casually slipped out of the room, off to a surgery that was to happen in 3 minutes time. I wanted so badly to ask what "optimistic" meant in terms of days, but I know he can't answer that. No one can.

Today was very quiet and I didn't do much. Dozed off and on this morning....dozed off and on this afternoon. Visited with my sister-in-law on her lunch. Enjoyed an evening with the hubby, a shower (if you want to call it that...more like rinsing off with a waterpick), yummy Chinese take-out, and some mindless reality TV.

My monitoring sessions went well. Baby Lewis is very "reactive" with good accelerations and decelerations...and of course, lots of movement. S/he is not so fond of me laying on my back with the monitor pushing on his/her little back. His/her main goal seems to be how the heck can I kick this thing off of me or get away from it. Sadly, I think this little one is just too wedged in there--head down and butt stuck in that one horn--to really move anywhere else.

At the end of both sessions, I had one contraction. Kinda' like clockwork as my bladder fills up and I've just been on my back too long. If I am on my sides, I simply don't contract.

Tonight I also was visited by my peri who did a vaginal ultrasound to see where my cervix is at. Overall, the length of my cervix is much shorter...last Thursday it was 3.37cm and tonight it was 2.25cm. It could be a little longer, but it was a different ultrasound machine and he said he was being very conservative...not giving my cervix ANY benefit of the doubt.

And of course, it looked fine. No funneling. Which is what it appears to be doing while my uterus is at rest. But, then he pushed on my uterus and there it went...shrunk down to nothing, right to the stitch creating that lovely little funnel. There is still about 5mm from the stitch with a little bit below it.

The good thing is that it isn't any worse and that it most likely isn't like that ALL day long...just when I am contracting...which isn't very often and almost always the cause of a full bladder and not any kind of preterm labor.

Still, it was disappointing and my peri definitely shared his frustration with my cervix as a few expletives came out of his mouth. He's a good Christian man, but clearly he was genuinely upset. I assured him that where my cervix is concerned, all profanity is completely allowed and justified...if not expected.

We all laughed.

He is fairly certain that after he speaks with my OB, they will agree to keep me here, mostly because it is safer and my darn cervix is just so unpredictable. We live 40 minutes from the hospital and it's just not a risk they want to take right now.

There will be discussion as the days progress of 1) whether or not to repeat that fFN test after 2 full weeks, and 2) whether or not to repeat the steroids after 2 full weeks. It just depends on whether or not I am still pregnant at that time and whether or not either will make a difference.

We are all settling into this new normal. It's hard on everyone, but mostly Robert. Between work, the girls, the house, the dogs, and well, ME...he has a lot manage. Not to mention at some point he must be dealing with his own worries, doubts, frustrations, and fears. Yet, he is a truly remarkable man and is simply taking it all in stride. Family is making adjustments and helping out wherever possible and for that, we are so grateful. We all know it takes a village to raise a child...but when you're talking about me, it takes a village to keep me pregnant. Thank you to everyone for your support, prayers, and helping hands...we appreciate you all more than words could ever express.

On antepartum floor and still cookin'...

So here we are...made it to an antepartum room on the 4th floor. It is quite tiny, but I don't need much space. Clearly it isn't a room meant for someone who has just had a baby because it's quite tight...no room for a bassinet, not even a couch or pull-out chair for someone to stay overnight. After a little begging I was able to at least get a small chair in the room for the occasional guest which will work just fine. I haven't had more than one other person in here with me at a time, so I can't quite imagine tonight's visit with Robert AND the girls. :)

YET...I am soooooo looking forward to seeing their little faces and snuggling with them even if it's only for a short time.

We've been trying to do Face.Time whenever possible and that has helped them a bit...I think. I'm still not quite sure if it's helping me or making it harder. It's just so hard to lay here and wonder when will I be home again? Will it be this week? Will I still be pregnant? Will it be a month from now? And again, will I still be pregnant?

And yet no one knows. (But if you do by chance have an idea, a vision, a hunch, a crystal ball...I'm happy to hear what it is!)

My OB was here this morning and said he wouldn't torture me with an internal exam today. My peri will be here tomorrow for another ultrasound and I'm sure my OB will do an internal as well. With those two pieces of information we should have a better idea of what is going on and what to do next...if anything.

Right now, I'm just trying to lay as low as possible and keep the weight off my cervix and give that stitch a little relief from all that it's trying so desperately to hold in.

I have shower and bathroom privileges still, so that's a good sign.

Still no contractions or cramping.

Baby Lewis looks great on the monitors and is doing very well.

Nothing else to really report. My IV might be removed soon...it's just a hep-lock right now, ready and waiting should they need to administer meds quickly. But it's been in for a few days and it's time to either move it to a new site or just remove it altogether. I will receive my lovely support hose in the next few hours as well to help with the circulation in my legs since I have been off my feet since Thursday. At least it's not the leg squeezers just yet!

Apparently there are lot of us "sitters" here in L&D and Antepartum right now...a bunch of women trying desperately to give our little ones more time inside. I am a bit further along than most of them and I know that many are facing the possibility of delivering soon and facing long NICU times if their babies are born now and, God willing, survive. I offered to reach out to them via the nurses...I know how this goes and I know how hard it is. I'm not sure if anyone will feel like chatting over texts, but I just don't want anyone to feel alone in this waiting game...especially when it's something you've never been through. It is a feeling of uncertainty, fear, sadness, guilt, anxiety, and worry, like no other.

You feel as though the fate of your child rests in your hands, well, your body...which is failing...yet you have NO control over it. None. What. So. Ever.

Sure, you can pray, you can hope...but you can't will it. You can't close your eyes and clench your fists and make your cervix get longer. You can't make your bag of waters magically reseal if it has ruptured. You can't make your blood pressure go down just by practicing some deep breathing. And you cannot tell your uterus to stop contracting...though trust, me, you try. No matter the complication that has led you here, your body will do what it is programmed to do...for better or worse...to ultimately save your life.

I just hope and pray that these women, and myself, are able to give our little ones the time they need. And truthfully, prayers and positive thoughts are about all we can really ask for and offer each other.

The latest

I am happy to say that today is ending on a much better note than it started on.

When I woke up this morning, my OB greeted me with a rather somber tone...which is very unlike the man he is, typically upbeat, optimistic, old school, liberal, relaxed in his approach.

He sat down by my bed and said, "Baby is doing fabulous, thank heavens for that. Our goal here is to give you that steroid shot at noon, do the fFN test in the afternoon, and hope that we can squeeze 28 more hours out of this pregnancy."

As if that wasn't hard enough to swallow, his last sentence as he walked out the door was, "I'm not going to make any grim predictions...but I think we're looking at delivery soon, unless we see some dramatic changes for the better."

And that was that.

GULP.

The steroid shot came at noon and ouch, it's a doozy. It's not that I don't like shots, well, not like I really DO, but when you receive up to 4 shots per day for weeks on end...shots just aren't that big of a deal until someone different does it. I'm used to the quick dart method, but man, these nurses are not so into that. Instead, it's the slow push in method and I just about wanted to turn around and do it myself!

My uterus has thankfully been very quiet, but just before the shot, I had one really good contraction...one that was about a minute long and took my breath away. I received the shot about 10 minutes later and proceeded to have 3 more contractions spaced about 5 minutes apart. I was really worried it was the start of something, but a quick trip to the ladies room and a roll to the left side did the trick and kept things quiet for another 4 hours or so. It seems my body is having about 1 contraction have 2-4 hours which is not labor.

Still, they are watching and waiting.

Contractions are what typically cause the pressure that allows the cervix to change. In my case, my cervix is changing without the contractions. My OB said the pressure of the baby who is quickly running out of room in my heart-shaped uterus is causing the changes and contractions will only make it worse. Right now, Baby Lewis is head down and tucked in the left horn of my bicornuate uterus. S/he did manage to flip head down in the last couple weeks, so there is room...but the right side is still completely empty and unfortunately very difficult for the baby to get to.

A few hours after the shot I had the fetal FibroNectin test done...yeeeeOUCH. That's all I'm gonna' say people. Read up on the method used and you will understand WHY it hurts so much ladies. Fortunately, I won't have another for 2 weeks...if the negative result we received truly means that I will NOT go into labor in the next 2 weeks.

That is, unless I am in the 1% category for which the test is invalid.

Ha, ha, HA...right?

My OB stopped in a little later and said he was very pleased at the test result and plans to assess me tomorrow or Sunday via internal exam to see if there are any changes, for better or worse. Fortunately the nurse who did the fFN test noted she did not see any signs of blood, discharge, mucus plug, and my cervix was closed.

There is a chance that if the contractions stay away, I might be moved to the 4th floor Ante/Postpartum unit for monitoring...either for the duration of the pregnancy OR until things take a turn for the worse OR until things stabilize enough to send me home on strict bedrest.

My peri came by after my OB and said he wants to do another vaginal ultrasound on Monday or Tuesday to see what is going on from inside and do a growth scan of the baby to see where s/he is at in terms of development. He is thinking that will all of the information from the tests, internal exams, and ultrasounds, they will have a pretty good picture of what is going on and the course of action to take.

So it appears that I will be here until at least Monday, possibly Tuesday. But maybe, just maybe, HOME after that...if I am still pregnant. Which trust me, I so hope and pray to be.

Not being home is hard...harder for such different reasons than when I was in the hospital when I was pregnant with the girls. Back then I missed my doggies and my husband.

Now I miss all of that...and my girls. And while I know my doggies miss me, and so does my amazing husband, our girls are having a hard time. Bedtime is our thing...our time together.

We have a wonderful routine and it's something I think the girls and I look forward to each and every night. Daddy doesn't quite enjoy it as much as I do...but he's on the fast track now.

It starts with getting ready for bed, cleaning up, brushing hair, brushing teeth, then getting into bed. The girls choose 1-2 books each and we read for about 20 minutes. After reading is singing time...their favorite lullabies and other quiet songs. Then it's our prayers. And finally our whispered "I love you's" and "Goodnights." All the while, their little heads rest on each shoulder and I stroke their hair. After the goodnights, they will usually roll to the opposite side and doze off in a matter of minutes, as I rub their backs. It's our snuggle time. Our mommy/daughter time without any distractions...and though it's a process that takes a good 45 minutes from start to finish...

...I cherish it.

So far I've had two nights without it and how hard it is. It's different than going away for a night to a hotel...I'm in the hospital which comes with fears and unknowns. The girls don't understand why I cannot be at home...why I am not coming home today...why I have to stay. We try to explain, but ultimately, they just want me there and trust me...I want to be there more than anything.

But daddy is there and doing an amazing job. Tonight Juliana had a very hard time falling asleep, so they called me and together, daddy and I put her to sleep. We sang our songs (and of course, I couldn't get through the last sentence of "You Are My Sunshine" without bawling my eyes out and having to put the phone down. Daddy came to the rescue and together we talked her to sleep.

He is pretty incredible...which reminds me, it's time for my bedtime phone call...so he can talk me down and to sleep.

I will update more as I know it, but for now, keep the prayers, positive thoughts, and good vibes coming...clearly they are working and we are so incredibly grateful for the overwhelming support.

With much love...

The time has come...

Ah yes, the time has come. Today I was admitted to the hospital, most likely for the duration of the pregnancy with a teensy, eensy, weensy chance I might be able to go home on strict bedrest. But folks, the chance is REALLY slim.

At 28 weeks, last Thursday to be exact, I had a day of tons of irritability and about 3-4 contractions an hour. It eventually eased up, but it was a it unnerving. I spoke with my doctor that evening and if things didn't settle down, I was to head to the hospital, but if they DID, I was to come in to see him first thing in the morning. The next morning I went in and the appointment went well. All checked out okay (no ultrasound) and I was sent home with a prescription for a tocolytic medication to stop contractions...to take "as needed." Thankfully, I filled the prescription and haven't needed it.

And still don't, but.....

Today I had a cervix check...no ultrasound of the baby, just my cervix. Oh, my lovely DYNAMIC cervix. Well, if it was dynamic last time, today it was nothing short of a show stopper. Literally.

Let me explain this ultrasound. The left of the picture shows the babies head. Yes, baby is head down now which explains some increased pressure and why when I looked in the mirror yesterday I suddenly had a space between my belly and boobs that hasn't been there for a few weeks.

To the right of the head is a black area which is amniotic fluid and the bright white outline that is sitting so nicely in that large funnel is my bag of waters, membranes, sac, whatever you want to call it. Continue to the right and you will see a dark line with bright white at he top and bottom...that is the cerclage or the stitch and the bright white little lines are the knots. That is what is reinforcing my jacked up cervix and keeping it closed...for now. Continue to the right further and the cervix ends where the area becomes a little lighter in color.

I wish I had a picture of the first ultrasound and actually, I'll have to text my peri to email me a picture of it for comparison. When he initially measured my cervix today, it was measuring 3.37cm (up from last time) and there was NO funnel. Where the black area juts majorly in and to the right creating that V...it was NOT there. It was a straight, well slightly curved line near the baby's head. That is what a NORMAL cervix looks like...if it stays like that.

Just as he was gushing at how great it looked, he applied fundal pressure to mimic a contraction (pushing on my belly) and we watched the monitor as that curve became increasingly V shaped and kept getting larger and larger and larger as my cervix got shorter and shorter and shorter. It seemed to stop...right at the stitch. He said there was only about 5mm from the end of the funnel to the stitch.

Five millimeters people. That's NOTHING. From the stitch to the external os or opening, there is about 1.5cm. But the long and short of it (no pun intended), is that the stitch is holding my cervix together and keeping this baby in.

PERIOD.

My peri then looked defeated, disappointed, and concerned. Flashback to the first time we saw him for this pregnancy and things looked so dire...that I would have to take medications to induce the miscarriage of two babies and possibly lose my uterus to save my own life.

Trying to lighten the mood, he joked with my husband, "I guess I might owe you that coffee Robert." And of course, my husband started telling him how he likes it. You see, they have had a bet this whole pregnancy as to just how far I'd make it. My peri said all the way, my husband said, 30 weeks.

Thanks for the vote of confidence, honey.

My peri then recommended, oh so casually, too, that I head to the hospital to receive the steroid shots just in case I were to deliver soon. He called my OB and had me stop there first and my OB confirmed via internal manual exam that I needed to go to the hospital. He could feel the pressure of the baby's head sitting right on the cerclage/stitch.

So here we are. I am settled into a nice Labor and Delivery suite for the time being. I received the first of two betamethasone steroid shots at noon and another will be given to me at noon Friday. Each shot takes 24 hours to "do its thing"...help mature the baby's lungs. So after 48 hours, we have given this baby the most protection we can provide if she or he were to be delivered within the next week. The effects or benefits of the steroids do wane over time. In years past, doctors would give high-risk patients like me the shots every 2 weeks until delivery, but research demonstrated that could have serious long term effects...so that practice is not generally adhered to anymore.

I will also have an fFN test done tomorrow after the second steroid shot. This test helps predict the chance of preterm delivery within the next two weeks. There is some question as to whether or not it will give us any more information or alter the precautions already being taken, but they are going to do it anyway.

The good thing is I am not having any contractions...some irritability, but not contractions. That means no meds for those just yet. Right now I just have to stay horizontal to keep the weight off my cervix...get these shots on board...and pray.

The first night in the hospital is always the hardest (sad that I've done this enough to know). We are in a much better place this time around in terms of gestation.

And knowing how amazing my girls are...my 27 weekers...it does put my mind at ease...a little bit.


Still, it's hard to not feel the sense of failure...yet again. Trying to push those thoughts aside, but mommy guilt is ruthless.


Praying, praying, praying...


...that Baby Lewis continues to do well...


...that we are able to receive both shots and give them the time they need to work...


...that my dynamic cervix calms down a bit and stabilizes...


...that the contractions do not come...


...that my membranes do not rupture...


...that the fFN test is negative...


...that we can give this baby the gift of time (3 more weeks to be exact)...


...that Robert is able to hold down the fort at home...


...that my girls will adjust to mommy not being home...


...that they will rest well tonight, despite knowing how hard it is on them all...




Please God, give us more time...

More

Well, here we are...

...officially MORE pregnant than ever before.

Surprisingly, I find myself a little more on edge now. Maybe it's because it's unknown territory? Or maybe it's because I feel like now we're working on borrowed time?

Or maybe it's because I just don't know how far this will all go?

Crystal ball anyone?

Unfortunately, my cervix and uterus are the only ones that know the answer to that question.

Fingers crossed, prayers said, that we make it to our next doctors appointments at 29 weeks and my cervix and uterus are still playing nice.

Email from peri...

My peri emailed me back today with his thoughts on my cervical lengths on Thursday...

"I believe that what the ultrasound demonstrates is that your cervix is quite dynamic. However, with that being said, both the resting cervical length [of 3.27cm], as well as cervical length after fundal pressure [of 2.95cm], are still both normal, even if it is the low end of normal. The most reassuring sign from my perspective is the fact that there is still ample cervix above the level of the cerclage [that is, from the stitch to the internal os of the cervix which opens into the uterus]. I think you can maintain your current activity level and rest as often as you can as you have been doing. The decision regarding hospitalization will not be made strictly on the basis of cervical length, but will take into account membrane funneling. If we see membrane funneling close to or at the level of the cerclage then I would favor hospitalization. My hope is that this will not occur."


When he talks about membrane funneling, he is talking about the internal portion of the cervix from the internal os to the stitch/cerclage sewn around and through my cervix, opening up like a funnel or capital letter Y which would allow the amniotic membrane or bag of waters to sag into the funnel. 


At 24wk5d with the girls, my total cervical length was 1.8cm, but from the internal os to the stitch, it was only 2 measly millimeters and funneled pretty much right to the stitch. And there was Baby A's bag resting in the funnel...which is why I was hospitalized.  


Right now I am resting in knowing that he considers there to be "ample cervix" between the internal os and the cerclage and no funneling. Still, I don't think I am as optimistic as he is. I feel fairly confident we can make it to 30 weeks...I would be thrilled to make it to 32 weeks...and I would be absolutely over the moon to make it to 34 weeks. 


We just have to wait and see...

27 + 2

Well, here we are at 27 weeks, 2 days...the exact gestation Juliana and Mia were born at. Looking down at my belly, I can't quite fathom having this baby today...that something so small could survive and one day be all that my little girls are. Amazing.

Simply, amazing.

My OB appointment went well Wednesday. They gave me all of my test results right off the bat. I passed the 1 hour glucose challenge test (phew), but my iron levels are borderline low, and my rubella titer continues to decrease. So while I don't have to worry about the 3 hour glucose tolerance test, I do have to up my iron intake and will most likely receive a rubella booster shot after delivery.

Weight was just up a pound to 158, so 23 pounds gained in 27 weeks. Heartbeat sounded strong and in the usual 140s range. Blood pressure 100/60. Fundal height 27.5...so just right.

He shared with me that he and my peri are very happy with how I am doing and he even went so far as to say I'm doing "fabulous."

Um, "me", "fabulous", and "pregnancy" in the same breath? Seriously?

We also talked about when it would be time to call it game over if things continued to go well. His biggest concern is my uterus and the chance of rupture due to the prior c-section done at only 27 weeks, the c-section scar itself, and the fact my uterus is heart-shaped and cannot expand as completely as it should. In his game plan, we will do an amnio at 36 weeks and possibly deliver...that is, if I haven't delivered by then already. I don't think he really plans for me to go any further than that because the risk of rupture is too great.

My peri appointment went well yesterday as well, but has left me with questions. My cervix is measuring 3.27cm and then with fundal pressure applied (pushing on uterus to mimic a contraction), it goes down to 2.95cm. Now that's not a HUGE change, but it is a change...whereas before there were no changes with fundal pressure. Any measurement above 3cm is considered normal...so do I fret over the 5/100ths?

Of COURSE I do people!!!

I ended up emailing my peri an hour later and asked him to really share with me his thoughts on that change with fundal pressure applied and he hasn't gotten back to me just yet. I told him not to rush, so I'm sure I'll hear from him tomorrow.

From the research I have done, the cervix...well, a normal cervix...should measure between 3 and 4 cm before 28 weeks. After 28 weeks, it will slowly shorten on it's own in preparation for labor. Measurements below 2.5cm are cause for concern and biweekly measurements...which I'm already doing and we're not quite there yet. Measurements below 2.0cm are really worrisome and usually mean bedrest and weekly measurements. Measurements below 1.5cm mean hospital bedrest.

The good thing is that the cerclage acts as a reinforcement to my cervix. The portions of my cervix immediately above and below my cerclage are thicker due to the scarring that the cerclage causes...therefore, it is more difficult for them to change and soften.

Now despite my frets over the .5mm I am below 3cm, my peri assured me things look great and he is very pleased. In his own words, "This looks like a 39 week pregnancy." When I asked him about my uterus and the chance of rupture, he was not nearly as concerned as my OB...which did surprise me quite a bit. I am guessing my OB will be the one that is watching my uterus very carefully and not him.

The last tidbit of info is that my last 17p shot will be at 34wk4d...if we make it that far. I don't have any refills after that and the peri said that's close enough.

There you have it...consider yourself up-to-date on all things Baby Lewis! We do have a website for this little one (finally). I have actually had it since October, but just wasn't ready to take the leap of faith of sharing it at that point.

It is a work in progress...one that will be worked on heavily in the next week as I add scanned ultrasound pictures, ultrasound video clips, and more baby bump shots. The journal entries are the same as the ones here and I plan to continue posting the same entries on both the blog and website.

www.ourthreemiracles.com

Stream of consciousness...

25wk6d...we are very close to midnight, so I'm calling it that. :)

I have so much swirling and whirling around my brain tonight...so much, that I just need to let it out.

The house is quiet, very quiet, and Baby Lewis and I are relaxing on the couch. Between 9:30-10:30, it's this little one's awake time, and boy did I ever cherish the little gymnastics routine that went on tonight.

In the past 24 hours or so, I haven't felt a whole lot of movement...really, nothing. It was quite unnerving and I found myself taking back all of the comments I've made to myself over the last few weeks about wishing this little one would lay off my cervix and kick elsewhere. Trust me, today I would have gladly taken a swift kick ANYWHERE, just to know s/he was okay. I poked, I prodded, I drank juice, I ate sweets, I laid flat, I laid on my side.

But nothing.

Finally at dinner I had two little taps and breathed a sigh of relief, but I still wasn't satisified. I wanted that big wallop and thankfully, it came around 10:00 tonight.

Exhale.

As I put the girls to bed tonight, I found myself kissing their little faces and thinking, "How can it ever be better than this?" In my eyes, they are perfection...every square inch of their little bodies. Even with the few lasting effects of their prematurity...the ones that will always be...they are perfect.

Despite being born at 27 weeks...a gestation we are quickly approaching with this one still tucked safely inside, they are perfect.

They survived.

They are thriving.

I'm not sure what I will do if/when 27wk2d finds us still pregnant. I'm sure I will wake up giddy with excitement and exhale a big sigh of relief, yet again. And if we are blessed enough to make it to 28 weeks, who knows what kind of party we'll be having!

In some moments, like now, it all seems so attainable. Yet in others...like the last 24 hours...I wonder if this is it. It's such a mental battle.

Of course, everyone has their guesses as to when this baby will come. Many friends and family are saying 32-33 weeks. My peri is thinking all the way. My OB is a little more conservative and just keeps telling me to make it to 28 weeks (as if I have any say in that). My husband says 30 weeks and when I stop worrying about making it to that point, my body will just let go.

Um, thanks honey for the encouragement.

I wish I could say I have my own guesstimate, but I don't. Really, I don't. I am living day to day and praying constantly that we make it to the next. I know all too well from my own experience and that of close friends and even complete strangers in blogworld, that things can be more than fine one minute and take a dramatic turn the next.

And really because of that very fact, I cannot think very far ahead. People are asking when I will start getting everything ready...pulling down tubs, washing everything, taking inventory. I start thinking about what we need in terms of "stuff" and I just can't do it yet. I even have a website for this baby, similar to the one that girls had for my pregnancy with them and their first two years of life, but it remains unfinished and barely set up. In many ways, I don't think I will be ready to think about anything until we hit 27wk2d...28 weeks even. Of course, I'm sure once we do hit that mark (God willing), I will be a crazed maniac trying to pull it all together in the final hours. But that's just how it's going to have to be.

11 more sleeps til 27wk2d...

The happenings...

It's been a busy couple weeks with the holidays, which is why this update is a little late. The good news is that it has the most current information since I had two appointments this past week!

Before we get to where we are at TODAY, I do have to confess that I found myself in Labor & Delivery (L&D) last week after two days of constant irritability and contractions. Around 5pm on Tuesday, that was it. I made the call and the doctor on call (my OB's partner) said because we were 23wk6d, it was time--time to head to the hospital to see what was going on...because we now had "a viable pregnancy" and if I was starting preterm labor they could give me the steroid shots. And by viable, I mean we had reached a point where this little one, if born, would have a 50% chance at survival. From this point on, the rates go up with each passing day, which is why every day means so much to us.

After drinking about 32 ounces of water in an hour...and despite having to pee every 5 minutes as a result...we made it to the hospital and of course, the irritability and contractions stopped. My uterus was quiet as can be on the monitor and the only blips were caused by the baby's gymnastics routine taking place every 5 minutes. After an hour and a half of monitoring, I was sent home. Since then, I haven't had a day like that...which may be due in part to my upped fluid intake which clearly makes a BIG difference in how calm or irritated my uterus gets.

By the weeks end, I would hit 24wk3d and spend Christmas at home...my Christmas wish. We even ventured out to the children's mass at the parish where my brother in law is a priest. It was a wonderful Christmas spent with both of our families.

Monday came, as did 24wk5d, and I had a growth scan and a cervix check with the peri at his new office in Burbank. The new exam rooms are amazing. They are huge with a large LCD monitor mounted across from the exam table for the patient to view the ultrasound as it is happening, as opposed to having to share the monitor with the doctor as you crane your neck to the right.

Baby Lewis was looking great, measuring right on track in all areas. We even managed to get a few decent 3D shots of the baby, but trust me, my children clearly do not like their picture being taken while inutero...that is, until they are born and then they know they have no choice!

I was super concerned about my cervical length, especially since I had the trip to L&D the week before and a few REALLY busy, on-my-feet-WAY-more-than-I-should days with pre- and post-Christmas activities. Thankfully, it was measuring good...okay...normal. It was our shortest measurement yet at 3.3cm, but considering it has been 3.76cm, 3.8cm, 3.4cm, 3.62cm, and now 3.3cm, my peri is still very pleased with it. It's kinda' gone back and forth between 3.3 and 3.8...which is a 1/2 cm range, but it's still above 3cm and that's fantabulous for me. I confirmed with Dr. I the "threshold" we were looking for which would mean hospitalization and he said anything below 2cm. My next check will be at 27wk1d...1 day shy of the day I would deliver the girls and right now I am just praying to make it to that point without any drama.

Thursday I had an OB appointment at 25wk1d and it was the usual pee in a cup, measure the uterus, take vitals, weigh me...ahem...YIKES...and talk about my concerns. My fundal height is around 26 weeks, so I'm still measuring a week ahead. I am up to 157 lbs....with clothes, shoes, and a jacket on mind you! That puts me up 22 lbs. at 25 weeks. We then talked about "the plan" and I finally got confirmation that I will NOT be trying for a VBAC. My only option is a c-section for a couple reasons:

1) I have a cerclage in place and in order to try for a vaginal birth, that has to be removed first. The question is when do you remove it? For most normal women, you do that at 34 weeks and then have the baby 4-6 weeks later. Well, for me, trying to pinpoint when is the right time is not easy. Once you remove the cerclage, the possibility for introducing infection goes way up and my OB was honest with me...he said he really doesn't want to take any risks here.

2) The most significant reason is my uterus is bicornuate, or heart-shaped, and it will likely be maxed out and stretched to capacity much sooner than term. The longer we go, the greater the risk of my uterus rupturing which is bad, bad, BAD. On a similar note, going through labor, contractions, and pushing could also cause my uterus to rupture and then here we are needing to switch to an emergency c-section and facing a life-threatening scenario.

3) Another factor to consider is the area of my prior c-section scar. Because I delivered the girls so early, the incision scar will be stretched much further this time if we reach 34-36 weeks and that area will be the area that will be the thinnest. In fact, we will start monitoring the thickness of my uterus in various locations starting at 27 weeks to make sure the risk of rupture isn't already here.

4) Vaginal birth and preemies don't go well together and the stress of a vaginal birth can cause more trauma and complications for the baby. And trust me, it's all about getting this baby here as safely as possible.

I guess I'm okay with all of this...I mean, I never REALLY thought I'd have a vaginal birth this time around, so I don't feel like I'm missing out on anything. Well, I take that back...the part I am sad about missing out on is the mother/baby bonding that happens immediately after birth...if/when the baby is stable. For me, the after-effects of the spinal anesthesia are not-so-great and include nausea/vomiting for anywhere from 6-18 hours; horrible itching; and a spinning room. I am not so sure that I will be in any shape to spend time with this little one...IF s/he is stable.

I've long since given up on my "dream" of a natural, water-birth. Ha. Ha. HA. Having your children at 27 weeks via emergency c-section will quickly make you realize you do what you have to do to get the baby(s) OUT. Period. You set aside your wants and do what is necessary.

The real question that remains is WHEN. When will all of this happen? How far will we make it? And how will it all play out? 

All questions to which I have no answers or even clues to answers. Clinically, this 'looks' like a normal pregnancy NOW, even though it clearly didn't start off that way...one that would otherwise go to term. But we all know that my body and this baby may have an agenda all their own. Who knows if/when the preterm labor will start. Who knows if/when my cervix will give out. And who knows if/when some other complication might occur.

And who knows...we could very well have none of the above occur and just continue to be normal.

I suppose we will just have to wait and see.