Water And Other Complexities

Living in the pacific northwest I am accustomed to water. Lots of water. It seems essential for growth, greenery, and fresh air. I love swimming, floating, and being around the healing power of water. I envision laboring in water and possibly birthing in the water, if the occasion arises. So when we had the ultrasound last month and the results came back that the amniotic fluid in my womb was on the very full side (between 95 and 97% - in the range of normal). I tried not to worry too much. I figured this baby just loves to swim, like me! I did the research about risks and talked with other pregnant women who had a lot of fluid and thought about the clients I've had with high AFI (amniotic fluid index) and came to the conclusion that since the baby is healthy and there are no issues with it's development and kidneys, and I don't have gestational diabetes, that I must be in the 65% range of women who have this "extra fluid" (for whatever reason) and we are healthy and there's no medical reason for it or explanation. It was fine to me to leave it at that and trust that when I give birth, my fluid will be the right amount for this labor and baby. 

Sounds simple enough, but when you have care providers that are concerned, you have to negotiate a bit. I understand midwives only serve women and babies who are in the medical ranges of normal and healthy. Once a woman is deemed high risk, she is referred to an OB who is trained in managing pathology in pregnancy and labor. Still, I wasn't thrilled about getting a second ultrasound. Lisa and Brooks flew in a week ago and we had an ultrasound and midwife appointment Friday morning. My fluid measured at 94%. Lower than the previous months ultrasound and only 1% away from being considered polyhydramnios. The midwives were still a bit concerned when I told them and said that after our appointment they would talk with their consulting physician about what the next step should be. We also talked about the two main risk factors that increase slightly if a woman has polyhydramnios. The first concern in a greater chance of prolapsed cord, if my water was to break before the baby's head is well engaged and the cord washes down first. This would result in the need for an emergency c-section as the baby would have no oxygen supply through the compressed cord. The other concern is that since a woman with excessive fluid has a more expanded uterus, the chance of hemorrhage after birth becomes a bigger risk. It takes longer for her uterus to clamp down and return to a smaller size, so the placental site can stay larger and more open for longer. Both of these scenarios would be emergencies and I understand needing to transfer if they arise. However, I still see myself as healthy with some extra fluid. I trust that whatever comes up, I will be well taken care of. I trust my midwives and their ability to assess the situation and make thoughtful and grounded decisions. 

When Eloisa (one of my midwives) called back Friday evening she told me that they want me to change my diet for the rest of the pregnancy in the hopes that it will help the fluid level go down and also make sure the baby gains the appropriate amount of weight. So far I've only gained 17 pounds in this pregnancy, so I feel that I'm doing pretty well. Also my diet was already really healthy. However, per their direction, I have switched to a very strict gestational diabetic diet/paleo diet. I don't have gestational diabetes, but one of the correlations to excess fluid (although not in all cases) is the body's inability to control sugar/carbs. I'm also supposed to check my blood sugar levels four times a day. One fasting morning check and the rest are taken one hour after each meal. After testing for five days my levels are always low and in a healthy normal range, not a diabetic range. It's a little frustrating to me that I have to change my diet to accommodate what a doctor thinks is best (even when I was feeling fine), but I'm hoping that it'll help me feel healthier and more able to bounce back after birth, I'd also love to give birth to a baby who is hopefully under 9 pounds at full term.

Other than the amniotic fluid and diet change, I'm doing okay. (Although I currently have a nasty head cold.) Baby is moving a lot and seems quite happy in his over-abundance of watery wombness. I love this little kiddo and am hoping we will make it to full term as I've been feeling soooo pregnant lately with aching hips and low back, extra sleepiness, lots of Braxton Hicks, and new stretch marks on my belly. I've gotten new ones every pregnancy, extensions of the ones that came before, slowly climbing up my belly. Marks of my motherhood, that I've lived this journey and earned my stripes. 

On the legal end, all is taken care of now and the surrogacy/adoption document have been revised and signed. We are all set to have Lisa adopt the baby after birth to make it official. Lisa and Brooks also found the perfect house to rent in Bellingham with a gorgeous water view. I know where I'll be spending my last weeks of pregnancy, on the sunny deck with Lisa, sipping unsweetened ice tea and kombucha. Two drinks I can have that are kosher in the GD diet. After baby is here, I'll be back on that deck with a mimosa in hand instead. hehe