30 week appt. (UPDATED)

Appointment today went okay. They did the fetal fibronectin check again. I should have the results of that tomorrow. Since it came back negative last week, I'm guessing it will come back negative today as well. If it doesn't, that's when they'll talk about bringing me in for hospital bed-rest. Fair enough.

My cervix was 1.5cm. It's short, but it's been that short before. So is it worrisome? Sort of, but not much more worrisome than its been for the last 7-8 weeks. So all I can do is hang in there and hope it holds up for another four weeks. In other news, my blood pressure is still great and I've lost another four pounds. Babies all have good heart rates, as per usual.

Dr. R's last day was today as she's moving back to Boston tomorrow, so she and I chatted for a bit while the sonographer did the growth measurements after Dr. R. had measured my cervix. This meant I missed much of the growth ultrasound, which I normally would have watched really carefully. Babies A and B are just about 3 pounds. Baby C is smaller, and its growth curve has slowed from the last growth ultrasound. There's really no telling at this point whether that's something to worry about yet, but they'll check again in a couple weeks to make sure Baby C is still growing, but at this point, there's really no way to tell whether it's worrisome. It probably isn't. And if it is, we'll deal with it when the time comes.

Also, the doctors are taking me off of home monitoring. It's clear that I have a good handle on what's normal for me. The last straw was essentially that last night I monitored, had to remonitor and still had 13 contractions. They wanted me to remonitor again, and I said I wasn't inclined to do so because this was normal for me and nothing unusual was going on, so I recommended they call the doctor. As it happened, Dr. R. was on call and she said, "She doesn't want to remonitor? Okay. Karen's pretty smart, I'm sure she'd know if something was any different. Let her go to bed." And that's how that worked. Honestly, that's mostly how it usually works. So the doctors pretty much feel like there's not much point in continuing with it. They've pretty much gotten the data they need from the monitoring: I contract a lot. They know that now. I know that now. The key now is that I know to call them if there's any significant change in the intensity or pattern. I noted to Dr. R. that I've been noting a bunch of subtle changes in my contractions in the last few days, but I wasn't sure if that mattered and she said no... they're looking for major changes in intensity. "You're not going to miss when you're in labor, I promise you." I do believe her. The contractions I had with my miscarriage last fall were DECIDEDLY different than the contractions I'm having now. I couldn't talk through them, they forced me instinctively into different positions in hopes of relief. So I'm pretty sure I'll know the difference.

I told Dr. R. what a hard time I was having walking/moving around and she wasn't surprised or alarmed. There's not a lot to be done about it, and it's just the way it's going to be and it's only going to get worse. I also told her I still don't think I need a stinkin' c-section and she did acknowledge that a triplet vaginal delivery ISN'T impossible. She cautioned that one of the things that makes it difficult in my case is that I've never delivered a baby before, which means I'd probably be facing a long, prolonged labor, which can present too much stress for the babies, or could leave me having to deliver one or two vaginally and STILL needing the c-section for the rest, and that's the last thing anyone wants, because recovering from BOTH a vaginal and caesarean delivery at the same time isn't pleasant... better to recover from one or the other. She said if I went into labor this week, it would absolutely not be an option, but if I make it to 34 weeks, I can probably talk about it with the remaining members of the practice, but of course, the first consideration will always be what is safest for me and for the babies. Understood and agreed.

I admit that part of why I don't want a c-section is that I'm afraid this will be my last pregnancy and therefore my last opportunity to experience a vaginal delivery. I also admit that part of why I don't want a c-section is because I hope this WON'T be my last pregnancy (as crazy as that sounds for a chick who's about to have four kids in her life) and I don't love the idea of having to convince a doctor to let me attempt a VBAC. But mostly... I just really don't want drugs running through that epidural if I can help it. I hate the idea of losing that physical control. I just hate it and it terrifies me, even though I know I'll get over it if it comes to that.

Edit: Two points of clarification: First, whether I have a c-section or a vaginal delivery, the doctor will make me have an epidural in place. The difference is whether there are actual drugs running through it. If I have a vaginal delivery, they won't have to run drugs through it unless I want them to, they just need it in place in case they have to suddenly switch to a c-section. And either way, I'd deliver in an operating room, again, just in case.

Second, my objection to a c-section has far less to do with having surgery, being cut open. or "losing out" on a vaginal delivery." It's actually having the epidural. I have two issues with the epidural, the first of which I clearly have to get over regardless and that's having a needle inserted into my spinal column. It's not a rational fear, so rational explanations and comments really don't help, and like I said, I obviously have to get over it regardless, so please don't try to talk me out of this one, because it won't work and will likely just cause me more anxiety. The other issue I have with the epidural is the actual drug going through the epidural, and this relates specifically to the loss of physical control of my lower half. I had a TIA (trans-ischemic attack, sort of a mini-stroke) when I was 23, so I've experienced the whole "you can't move your limbs no matter how hard you try" sensation before, and it's excruciating for me. I don't relish the idea of doing it on purpose. Again, if I have a c-section this is just something I'll take a deep breath and get over, so there's no need to try and talk me out of it.. most attempts to try and soothe my fears about such a thing only make me more anxious about it, so trust me when I say that I really will just get past it, but I really do have a pretty straight-forward reason for not wanting an epidural, and therefore not wanting a c-section. (This, by the way, makes me even MORE opposed to having a spinal, which can't just be turned off, so I'm REALLY hoping that's not what happens)

As for pain relief, I really am not that concerned about it. I'm fully aware that my only real pain relief option is an epidural even with a vaginal delivery. But pain doesn't worry me. I have a lot of chronic pain in my life. I know how to handle pain. I have a lot of techniques in my arsenal (so to speak) to handle pain. I have chronic migraines. I have chronic kidney stones, many of which I've gotten through without any pain relief (kidney stones are often likened to the pain of labor, and often women who have had both labor pains and kidney stone pain say that kidney stones are actually worse). Believe me, I'd much rather have to deal with pain, which is finite, than an epidural (which, admittedly, is also finite).

There is also the minor fact that I'm not loving the idea of taking care of triplets while recovering from a c-section, but I don't imagine it'll be all that fun to recover from delivery of triplets no matter what, so that's a pretty minor issue. End of Edit

30 weeks, Dr. R. emphasized, is a big milestone. And 32 weeks will be a bigger milestone. And 34 weeks will be huge if I can get there. I'm definitely getting there. Not far now and I know I can get there. Back for another appointment next week.