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15 weeks | Baby #4

January 15, 2017 | 15w1d

Baby is the size of a navel orange now, and I'm pretty sure he or she had a major growth spurt this week. Either that, or my uterus suddenly gave in and I've popped. For those that scoff at my bump, just refer back to my four week picture to understand why this seems LEGIT to me. I forgot about how most people are always 'you are so small' to me when pregnant. I don't feel 'small' but I guess it's all relative!

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I'm feeling really good overall. I'm hungry and can eat pretty much whatever. I have decent energy and have been walking on the treadmill a little bit. I'm wearing maternity pants for pure comfort but regular pants are 'fine', too. For now. I'll feel the baby kick here and there, nothing consistent yet. Especially in the evening hours, it's 'for sure, not just gas' taps!

My first OB appointment at 14w3d needs recapping here.

Doppler showed the baby's heart rate 152, and I didn't have the guts to tell her I have my own doppler at home. I've been checking maybe once a week lately, but still! She always does an ultrasound in her clinic, and went for it this time, too. It showed a 'big baby' about four inches long, I saw one big movement and the baby's hands were up at his/her face. Beautiful heartbeat. Beautiful baby, so much bigger than last time at 8 weeks! No mention of the bleed, but if baby is 4 inches, the bleed was about 2 cm last time so I'm guessing it would be hard to see even if there. 
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I'm up two pounds, shocking it's not more. BP was a good 120/63. 

We talked about being AMA, and I was preparing myself for her to be a little 'strict' about it, just knowing her personality. She did raise her eyebrow slightly and say, 'you are 35 now?' I am going to get the quad screen at 16-18 weeks, just as I've always done for each pregnancy. I will have my 20 week US with a perinatologist at the hospital instead of going to the clinic with an ultrasound tech like I've done before. This will be pretty cool, I think, because we will get to see a lot and will hear the doctor tell us basically everything right then and there. Also a growth scan at 32 weeks will happen, which again sounds great. When she heard that I was bleeding again before 6 weeks her already slightly concerned face about my age got a little more intense. 'This is when I go into my talk about AMA.' 

The baby could be sending us signals that something is not right (because of the early bleed) and any of these things could happen: birth defects, premature birth, or still birth. Great. Fun talk. 

I realize she has to say these 'worst case' scenarios to me. And sure, the risk goes up slightly at age 35 for some birth defects. And it's not great that I bled at 6 weeks. But a birth defect is not THAT much more likely now than it was with Porter two years ago. I looked it up and Down Syndrome is a 1/600 chance at age 33 and 1/350 chance at age 35. 

And you know what? It's out of my control. This is happening and worrying about all that can happen will get nothing accomplished. Not one thing. I know I will still have my moments when I worry about this baby, but I feel like making a conscious effort to assume the best right now. We will cross each and every bridge that comes along. The first being the Quad Screen in another two weeks. Then the big ultrasound. 

Today I am pregnant and I love my (healthy) baby. I've been worried about each and every one of my babies before this, even without being AMA. This is really nothing different for me, mentally. 

Lots of women have healthy babies at and beyond age 35, and I guess I was just hoping my OB would be very 'meh' about my age. I still get to be 'meh' about it if I want to be, though. And I am not going to stress.

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She was also super excited for me and I don't want to discount her positivity. She has four kids of her own and said that four is a GREAT number and she just loves my kids, and loves that we are having another. She wanted to see a picture of them and said I should bring them in for a few visits, then marveled at how huge Truman is and at Cecelia's hair. I got a few big hugs, and it's great to be back with her. She knows I had to switch back to my own medical insurance in order to see her and knows that this baby wasn't planned. We talked about our house addition, about the kids, and life. All of my initial blood tests looked good, and I'm all scheduled for going back every four weeks until 26 weeks. It was quite surreal being back in her office again, and even her nurse said, 'You're back! Welcome!'

I mentioned it in my Day in the Life but I'm all scheduled for my 20 week ultrasound on February 16th. That's so soon, it's nuts! Cannot wait. Still thinking girl and kind of just want to enjoy the ultrasound and let the tech tell us the sex while we are in there, so we don't have to turn our heads half of the time. Then the 'reveal' can be more for the kids later in the day or something.

Surreal.
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What else? I don't know. Am I supposed to look up my old 15 week posts to compare or something? Haven't done that yet, probably should! I did see this in my Timehop the other day....was exactly 14 weeks along this year, too (since my due date is identical to Porter's).

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Bottom line: things are feeling more real, things are feeling positive, baby is tapping occasionally, and I have a feeling the next six months will fly at warp speeds.

17 comments:

  1. Try to take all things "AMA" with a grain of salt. I'm 45 now and had my kids at 39 and 41. I was monitored fairly closely but for other reasons - my AMA didn't seem to phase my OB for the most part and my ultrasounds were in the usual clinic (even for the 20 wk u/s's) and my numbers for downs were low the first time (1/280) and a bit higher the second time (1/700) but we never pursued further testing knowing that our numbers included the statistical floor which brought us down quite a bit. (if that makes sense?). I'm not sure if they do things different in Canada or not but we just decided to do what it sounds like you're doing - enjoy the ride! You look amazing, by the way!

    Lisa (from Canada :))

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    1. This does make sense----We are enjoying the ride, for sure!

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  2. Ahhh! Love it all!!! That bump is PERFECT!!! Just adorable!!! So many props to you for staying sane!!! I have to try so hard to discipline my mind to worry about only what I can change. God made this baby just for you & Nate :) and he/she will be perfect!!! I am so excited to see if it is a boy or girl!!!!!!!!!!!!!!!!!!!!!!!!!!! Also? I continue to read "Against Medical Advice" for AMA LOL. Like, continually have to make myself realize what you are saying. LOLOLOL. I guess you just don't seem over 35 to me!

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  3. I just had my second at 36 and my doctor did not even talk to me about AMA. This might be because she had 3 after 35 herself. She had told me before she doesn't see it as a concern until after age 37. I did the genetic testing at 10 weeks but that was the only AMA thing we did and she said might as well do it since insurance will pay for it.

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    1. Good point, I'm pretty sure my OB had all 4 of her kids back-to-back an wanted to be done at age 34. So she is biased about AMA, the opposite way that yours is! I'm glad you didn't have to worry much about being 36, which is still SO YOUNG!!!

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  4. hey Julia, been following your blog since before Truman (crazy) and have only commented like twice, but I just had to weigh in today. Congrats on baby #4! The reason I had to weigh in is that I've been making myself absolutely nuts worrying about AMA. I am going to be 32 in a few weeks and have no kids yet because...well... life doesn't always work out the way we imagined it would :) Anyway, I certainly hope to be pre-AMA for baby #1 but I probably will be AMA for baby #2. I'm from a big east coast city (although living out west) and on the east coast women have babies OLD. 35 is a totally typical age for even a first baby. In fact, having a baby before 30 is borderline taboo (weird how regional culture differs, huh?). I tell you all this because despite the epidemic of AMA back east, there are TONS of healthy babies and mamas and OB's barely bat an eye at it. That's gotta mean something. I am neurotic like you, so I just tell you this in commiseration. I know I am always looking for positive stories to cling to.

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    1. Hi, Julia~Agree, I'm sure there are parts of the US that don't even bat an eye at 'AMA' status. I wish my OB was one of those doctors, that is for sure! But alas, she is not and so I will deal with it the best I can. Lots of success stories for babies born to moms well beyond 35!

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  5. I had a miscarriage at 33, healthy baby at 34, loss due to a genetic abnormality at 36 and healthy baby at 37...so for what it's worth, AMA is just another number.

    When I lost my 3rd pregnancy we talked to a genetic counselor, and what she told me was totally a light bulb moment: there's nothing magic about age 35. There is always a risk of genetic abnormalities, and it increases with each passing year. The quad screen is good, but has a lot of room for error so prior to a few years ago, amniocentesis was needed to confirm genetic issues, and amnio carries a slight risk of miscarriage. Around age 35, the risk of having a genetic issue has risen enough that it's about the same as the risk of having an amnio to test for one. Nothing about genetics or fertility drops off a cliff at age 35 -- it's just where the risk/probability curves meet.

    I hope I explained that in a way that makes sense. Anyway, it was really helpful to me when deciding whether to try for a 4th pregnancy/2nd kid because it helped me see that despite my two losses, the odds were still in my favor to have a healthy kid. Which I did/do. :)

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    1. I appreciate this, Sarah, and totally get it. I was looking up info on AMA and saw the same stat about how age 35 is when it use to 'cross' for the risk of defects and the risk of an amnio. Of course, amnios now are a lot better than they used to be, too! It makes sense that age 35 is not a magical number, when genetics 'drop off'---yes, that is a great way to put it!! Thank you!

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  6. The picture looks like a boy :)

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  7. I was almost AMA for both of my kids (first one snuck under my 35th birthday). The more extensive 20 week ultrasound is nice because they really do a good job with looking at everything. They will do extensive pictures of mainly the brain and heart so just be prepared for that. But you are right, nothing you can do about it so it's better not to stress about it (if you can).

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  8. Hi there, congrats on the pregnancy! I had my first two kids before by the age of 34 so, as far as testing goes, I just did what you are doing for general reassurance but nothing was ever guaranteed. I know if I have a 3rd baby (I am 37 now) I would be encouraged to do more testing. I agree with the other comment that in the large urban centers people have babies much older. When I had my kids I was by far the youngest mom in all the mommy groups. Now, considering having another at 37 or 38 feels a bit more anxiety provoking because of the odds of complications but is definitely not uncommon given what I see around me. My question for you is why not do that new bloodtest they offer at around 12 weeks that supposedly is nearly as accurate as an amnio? I don't know the exact name for it but everyone I know who has had a baby in the past few years has had it done with excellent results. It is completely non-invasive (they somehow look at the fetal cells in your blood and analyze those for abnormalities) and only if something was amiss would they recommend going for additional more invasive tests. I realize that the results may not affect your decisions either way but perhaps the reassurance would feel great. Anyhow, best wishes whatever you decide.

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    1. Hi Miss Amanda Jones~Thanks! The reason I didn't do the first trimester screening for defects (called the Harmony here at least) is because it has to be done before 13 weeks. I didn't see my new OB with new insurance until 14+ weeks so it was too late to do the test. I did call and spoke to an RN before this appointment, when I was with my previous OB/insurance, and she sort of poo-poo'd the test. Said it might not be covered by insurance, is $3,000, and basically tests for the same exact issues as the Quad Screen at 16 weeks, and of course the anatomy scan at 20 weeks. Peace of mind would have been nice (it WILL be nice!), but I also dread waiting for test results. Like, it is extremely difficult to carry on and not think about getting that phone call. I'll have to do that for the Quad Screen anyway, and I always have. Adding one more test to the mix seems to just drum up a lot more anxiety for me, and with the insurance switch it really just didn't work out. I didn't want to have the test done with the other OB because I never had a single appointment with her, only ultrasounds in the radiology department. So I never heard her personal opinion on the test anyway!

      Hopefully that makes sense! My good friend did the first trimester screen this time, she had great results and I did wish I had it done at that time, too. But now we are just a few weeks away from the ultrasound and one week from the second tri blood screen, time flies!

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    2. I was thinking you would have a comparison belly shot in the post. I love a good comparison shot! As far as AMA, if we decide to have a 3rd, I'll be AMA (I turn 35 later this year). I would say it's not a huge factor in our decision but the thought of being older with a newborn makes me think we'd be crazy. IF only it was an oops baby, out of my hands. Can't wait to find out the gender! Always exciting.

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  9. Congrats on the pregnancy! I'm another long time reader but not a commenter (maybe once or twice?) but wanted to join in the other reassurances about AMA. I just had my first baby last summer right after turning 35, so I was considered AMA. The AMA stuff was a non-issue at my OB. Interesting how different OBs have different perspectives. I also had gone through several IVF attempts in order to get pregnant, so I was very nervous, especially because I had 3 bleeding episodes in the first tri. That was super nerve wracking and I saw that you had to deal with that too. My ultrasounds never found any SCH so it I never got a good explanation for it, but my reproductive endocrinologist was also pretty nonchalant about the bleeding. I guess they see it a lot and things turn out fine. I did do the cell free DNA testing because it was hard to accept that my pregnancy was real, and getting those results (plus finding out the sex!) was a huge relief and helped me enjoy the rest of my pregnancy. Sending good vibes for your quad screen and hope you get those results quickly! My pregnancy went by so fast--time really does fly!

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  10. Omg I am so excited for you (and jealous). My kids are 5,3 and 1 and I have that niggle in my head for a fourth. Unplanned seems easier somehow. Damn you mirena!

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