Pregnant with Baby Number Two - The Third Trimester

The third trimester... wow can you believe it? It's bittersweet, because this likely will be my last. Only time will tell..

Some things I won't miss about pregnancy include:

Back Pain - My back pain this pregnancy has been horrendous. It's so bad it damn-near brings me to tears. Thank God for a heating pad. There are many things that contribute to back pain during pregnancy - weight gain, posture changes, hormone changes and muscle separation, according to WebMD. After doing a little more research I decided to try the Belly Band. I was a little skeptical, but WOW! It was life-saving. I put it on and my back pain is almost non-existent! I wish I would have used it earlier.

Frequent Urination - I'm pretty sure I am up peeing every 15 to 20 minutes. At least I'm getting my steps in?

Insomnia - There's nothing worse than being exhausted but not being able to rest. I feel like I have a million things to do before she gets here, and I'm constantly making lists of what needs to be done/purchased/cleaned, etc. Thank goodness I am able to take naps when I can!

But then also Exhaustion - Third trimester exhaustion is no joke. Not only do I feel like I could sleep all the time (even if my mind won't let me), just the physical exhaustion of being pregnant and chasing around a 3-year-old makes me want to nap forever. When I get up in the morning, I'm already calculating when I can lay down again.

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It's Hot as Hell - If you are planning out your pregnancy, I HIGHLY recommend you avoid being pregnant during the summer months. The Missouri heat and humidity has been awful. I feel like I can't be outside more than a few minutes without just feeling miserable. Air conditioning has been my best friend!

A few things I will miss...

Hair Growth - My hair hasn't been this long since I was a freshman in high school! I'm loving the luscious locks, just not looking forward to that postpartum hair loss. The only downside to hair growth is the hair on my legs grows longer and faster, and it's getting more and more uncomfortable to try and reach them to shave. I can't hide it with pants either like I did in the winter with Henry's pregnancy.

Baby Kicks - Unless you have experienced yourself, there is no way to explain the feeling of those baby kicks and jabs coming from the life inside of you. It's a constant reminder that she is there, and I'm forever grateful for her healthy kicks. It's my favorite part of pregnancy, by far. It's also important to get familiar with the movements of your baby. In fact, most doctors recommend you start a "kick count" around 28 weeks. You should be able to feel about 10 kicks, or flutters, rolls or some type of movement within two hours. While it might seem silly, noticing those movements, or lack there of, could be the sign of something more serious.

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COVID-19 Vaccination - First Dose

To be completely honest with you, I went back and forth on whether or not I was going to get the vaccine. Yes, the thought of getting and/or spreading the virus was scary, but the thought of something happening to my child because of the vaccine terrified me even more. Without getting into too much political/science debates, after speaking with my OB, she said she felt 100% comfortable with me receiving the vaccine during the third trimester. That doing so while she was still in utero, along with breastfeeding once she's born, is the best protection she will get from the virus. There is about six months worth of data behind pregnancy and the vaccine now too, and after reading up on various sources, I felt comfortable receiving the vaccine, as long as it was the Pfizer or Moderna. At 27 weeks, I scheduled my first dose at CVS. I received the shot and didn't have any complications or side effects other than a sore arm for about two days. I go again in three weeks for my second dose. I hope I am lucky and don't have any issues with that one.

Since there isn't much data on pregnancy and the COVID-19 vaccination, I am participating in the Centers for Disease Control and Prevention's V-safe After Vaccination Health Checker. Put simply. it's a source that collects data of pregnant women after receiving their vaccine. Each day during the first week, I get a text message asking me a few questions to see if I am experiencing any issues since becoming vaccinated. Then I do a checkup once a week until my second dose. My hope is that they will be able to collect the data to provide valuable information to expectant mothers in the future trying to make the right decision for their families.

To register for the v-safe program, click here.

28 Week Appointment, Glucose Test and Growth Scan

This might be one of the most dreaded OB appointments a pregnant woman will attend. The glucose test isn't horrible, but it's definitely not the best. Leading up to my 10 a.m. appointment, I could only eat protein. So I made myself some eggs and sausage before hitting the road. I got to the office a little before my appointment and got checked in. The lab tech took me back and gave me the lovely oral glucose tolerance beverage. The crappy thing is, they were so busy that they ran out of cold ones. So, I had to drink it at room temperature. The drink tastes like a flat orange soda. Again, not the worst, but definitely not a delicious beverage. I gulped mine down in a few minutes, then would need to wait an hour before they could draw my blood.

Oral Glucose Tolerance Beverage

During my hour wait, I also had a growth scan done. I'm having this scan due to my high risk pregnancy (preeclampsia and IUGR with Henry), so they are just being extra precautious. Baby girl was stubborn, just like her brother in utero. She is head down and her heart rate was 155 bpm. She is measuring 2 pounds, 12 ounces and is measuring a week ahead. So doing great! The new tech wasn't able to get any great pictures, so I came home empty-handed, but it was still amazing to see how much bigger she was getting. It was also kind of fun to have the tech feel her kicks and react to them.

Next I met with my OB. My BP was decent this time and not concerning, another good sign things are still on track. We did a little digging and made note that I was diagnosed with preeclampsia at 32 weeks last pregnancy. So, each week I can make it without any problems, is another week that baby girl stays inside! She told me that women who have had preeclampsia in their first pregnancy have about a 30% chance of having it again. So, fingers crossed!!! We also discussed again that no matter what, I did not want to be induced. So its either I go naturally into labor, or we keep the August 31 C-section date. Only time will tell.

My hour was up so I got my blood drawn. They are also checking my liver enzymes - another sign of preeclampsia. We scheduled my remaining OB appointments, and now it's just making it through this summer heat.

Whomp...Whomp... I failed my One-Hour Glucose Test....

I failed my one-hour glucose test, so I have to go back for the fasting, three-hour test. Bummer.

Three-Hour Glucose Test

For this test you have to fast for eight hours prior to the test. When I got to the doctor's office, they first draw fasting lab to get a baseline. I was then given my oral glucose tolerance beverage. This one was tough to get down. It is super sweet and made me so nauseous. I had to will myself not to throw up. Then for the next three hours I would get my blood drawn every hour on the hour. It wasn't too terrible as I just took a book and my laptop to keep me occupied. I survived, but was definitely ready for lunch at the end of that third hour! Lab results be available in about two days.. Fingers crossed!!

3D Ultrasound

This is one of my favorite, most anticipated parts of pregnancy. It's literally a sneak peek at your baby! I tried to prepare as best as I could the days leading up to my scan; drinking lots of water, but my kids are stubborn, no matter what I do. Unfortunately, my mom wasn't able to attend due to a family emergency, but my mother-in-law, Drew and Henry were able to go with me. It's a 30-minute scan where they try to get images of your baby's face. Of course, baby girl wanted to snuggle up to her arms and hands, so we only got partial pictures. Henry got to pick out a heartbeat animal - he picked the unicorn - and we got a recording of baby's heartbeat. These images just make us more anxious for her arrival!

We highly recommend Prenatal Imaging, LLC off Barry Road in Kansas City. They have always treated us well!

COVID-19 Vaccination - Second Dose

I received my second COVID-19 vaccination dose on Sunday, June 20th. It was quick and painless, just like the first. My only complaint so far has been a sore arm.

30 Week Appointment

The main concern during this appointment was the fact I have had a headache for the past week. It's unclear at this point what the cause is; allergies, tension headache, or possibly my blood pressure. While my BP is not ideal, it's not too high, but we will continue to monitor it. Doc gave me a prescription to help with the headache, and we will keep an eye on things. Another issue was that I unfortunately failed my three-hour glucose test. She said my fasting numbers were normal, but it spiked at the one and two hour mark. So I will be meeting with a dietitian, and monitoring my blood sugars. From there, I will meet with a high-risk doctor to discuss what my options are moving forward with the rest of the pregnancy. The worry now is having a big baby. At week 30, you are also supposed to get your Tdap vaccine, but since I just received my second dose of my COVID-19 vaccine, we will wait and do that at the 32 week appointment.

Meeting with a Dietitian, Learning How to Check My Blood Sugar

For this appointment, I met via video conference. I picked up my blood glucose monitor a few days prior and had it ready to go over on the call.

Since I had been testing about a day and a half before my call, I was able to provide the dietitian the numbers I had been tracking. My meter, the Accu-Check Guide sends all my test levels to an app on my phone, so it's easy to keep track and get an average of my blood glucose.

My first full day of testing looked like this:

Fasting BG: 109

2 Hours After Breakfast: 110

2 Hours After Lunch: 114

2 Hours After Dinner: 116

These numbers are not horrible. This was before I really started to watch my carb intake.

I learned during my call the following information:

My fasting BG in the morning should be 95 or less.

2 Hours After meals, it would be 120 or less.

So my biggest concern is that fasting blood glucose.

My dietitian also told me I should stick with these carb ranges:

Breakfast - 15 to 30 carbs

AM Snack - 15 carbs

Lunch - 30 to 45 carbs

PM Snack - 15 carbs

Dinner - 30 to 45 carbs

Bedtime Snack - 15 carbs

We would start low and see what my numbers are, and go from there.

The second part of the appointment, I met with a registered nurse to make sure I understood how to use my monitor. I had some trial and error but I think I have it down now. We discussed the risks of GD and what it could mean for the remainder of my pregnancy.

I was also told that if I had two readings that were out of range, I needed to call/message my dietitian. So after a few days of testing, and I messaged her because I cannot seem to get my fasting numbers down. They are stuck around 104. So we will see what she recommends.

32 Week Appointment/Meeting with High-Risk Doctor

For these appointments, I ended up having to take half a day off just to accommodate all the appointments. The first appointment was Dr. Florio, who specializes in maternal and fetal medicine. While appointments like this can be rather intimidating, she was very down-to-Earth and even talked about her issues with preeclampsia during her pregnancy. While preeclampsia is not the issue this pregnancy, we did discuss my pregnancy with Henry and all the issues that came with it. She also let me know that I've hit the trifecta of issues as far as preeclampsia, growth restriction and diabetes between the two pregnancies, and that my risk of heart-related issues in the future is much higher. She recommended that after my 6-week postpartum visit, that I also follow up with a cardiologist or PCP to keep track of my heart. All stuff I should be doing anyways, but another wake-up call to take better care of myself so that I can be around for a long time for my babies.

Since my fasting numbers continue to be out of range (higher than that 95) we decided that medicine would be the best route for me. She said that I can do everything in my power (diet, exercise, etc.), but at some point, my body will just continue to fight me on those fasting numbers. Meaning, the only option is medicine. So I could either start insulin, or a pill called Metformin. She said both options are used widely in pregnancy. Insulin, is a shot that I would have to give myself, or the Metformin, I could start out taking twice a day. The major differences are also that Metformin crosses into the placenta; insulin does not. We also discussed that the Metformin could help stabilize baby girl's blood sugars after she is born - something they will monitor regularly to ensure she is doing well after birth.

We decided to give the Metformin a try first. I will take 500mg twice a day starting out. We will see how my body tolerates the medicine and go from there. I will also be required to do growth scans, or a BPP (Biophysical Profile) every week leading up to birth.

Next I met with another dietitian. We looked over my numbers since I have been tracking them. She said they weren't that out of range, but it is something we can play around with to get a better handle on things. She said as my pregnancy progresses it will be harder to keep all those numbers in check. Thanks hormones. We discussed some better bedtime snack options and her main tip is to always pair carbs with a protein. Protein and fiber help slow down the body's response to sugar, and can help stabilize my numbers better.

I am also required to track my sugars (as I have been) but to send them to her every week. So every Friday, I will get on the hospital's portal and send in my numbers. From there, they will decide how to progress with the pregnancy.

The last appointment of the day was with my OBGYN. They checked my BP, and it's holding steady (thank God!). I got my TDAP vaccination, and had a quick visit with the doc. Baby's heart rate is measuring beautifully, as well as my fundal height. We also discussed the hospital's policies regarding Labor & Delivery during COVID. She said she doubts with the uptick in cases that anything will change, but as of now, the support person is allowed to leave for food or whatever, without any issues. I no longer have to take a COVID test prior to coming into the hospital for my scheduled C-section.

BPP - Biophysical Profile and Non-Stress Test - Week 33

The first part of the morning I got to see baby girl. The ultrasound tech took her measurements, and determined that baby girl weighs 4 pounds, 11 ounces, just about two days off from her estimated due date. She is on the smaller end, but nothing alarming at this point. The next part of the biophysical profile is they look for a few different things: baby's heart rate, muscle tone, movement, breathing, and the amount of amniotic fluid around baby. She then gets a score out of 8. My baby girl scored an 8/8. Yay!

Next is the non-stress test, or NST. This non-invasive test involves attaching one belt to mom's tummy to measure fetal heart rate, and another to measure contractions. According to the American Pregnancy Association, they track movement, heart rate and "reactivity" of heart rate to movement for about 20 to 30 minutes. If baby isn't as active, they may use a small buzzer to wake baby up - which they've had to do for both Henry and baby girl!

What they are looking for is adequate blood flow to baby. Things looked great and my blood pressure was decent. So we are on to another week!

34 Week Appointment

Another short and sweet visit - doctor checked my blood pressure - elevated but not horrible, and then baby's heart rate. She also checked my blood sugars from the previous week and said everything is looking good. Next visit I will get my Group B strep test. Yay..

BPP - Biophysical Profile and Non-Stress Test - Week 34

Little miss decided to tap a nap during the ultrasound portion of my BPP. Fortunately, she did all she needed to do to score her perfect 8/8. The NST was uneventful. 10/10 for the entire morning.

BPP - Biophysical Profile - Week 35 and 36

Baby girl wasn't as active as they'd like. Technically she failed her test, but they weren't too concerned and would just keep an eye on me for next week.

And unfortunately, I tested positive for Group B Strep. That this means is that when I go into labor, I will need to have IV antibiotics prior to delivery.

During these last few weeks, I also had two visits to Labor & Delivery. (I'm writing this post-delivery, so I am a little unclear on the exact dates). The first time I ended up there because after a prenatal visit with my OB, she decided she wanted me to be monitored for my blood pressure. It was high in the office and I was complaining of a headache, but once I got over there, it was back in slightly elevated range. They gave me some Tylenol and checked on baby and sent me on my way.

The second time I went because I was worried I hadn't felt her move in a while. The tech had me nervous because in the last scan my amniotic fluid was low. They warned me that if I felt like there was a decrease in movement to come in immediately. So I made myself believe something was wrong with my baby, and went in. Once I got there, the L&D nurse told me that they want one movement an hour, which is what I was feeling. They just scared me into thinking it should have been more - so nothing was really abnormal. Too bad I have to pay for the L&D visit anyways... I guess peace of mind knowing she was ok.

Preparing for Birth

As the weeks were coming to an end, I was pretty emotional. Just anticipating how life was going to change and how my first baby - my Henry - was going to do. I used these last few days to soak up the moments with him as an only child and praying for a safe delivery, not knowing what was about to come our way...

Soaking up these last few days with my baby before he's no longer my baby

I'll work on my birth story post and have that up soon!

XOXO

Lauren

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