Dr. Real Deal recommended that I get sonograms twice a month. Since my age and one of my health conditions put me at a greater risk of premature birth, she wanted to check to make sure that: 1) the fetus was growing properly; and 2) my cervical length fell within the normal and safe range.

(As a woman’s body prepares for labor and delivery, the cervix actually shortens or becomes more effaced.  After that, it then stretches out to prepare for delivery, also known as dilation. Both effacement and dilation are measured in centimeters. If a woman's cervix starts to significantly shorten before the third trimester, there’s a strong chance that she will go into labor prematurely.)

So, now that the anatomy lesson is behind us, what happened in my sonogram?

January 7, 2013

At my 18-week sonogram, the technician looked at every organ, every extremity and every vertebrae of the fetus. It was interesting to see how much could be revealed at such an early stage in the pregnancy. As she moved through each region of the fetus' body, the technician checked various items off of her list. Thankfully, everything was developing as it should.

Although the technician had access to a folder with the baby's gender, she wanted to confirm this herself. Since the fetus wasn't in the right position for that, the technician took the ultrasound wand and painfully jammed it into my lower abdomen. She did this on several occasions throughout the exam.

“This thing is stubborn!” she exclaimed. “It’s almost as though she’s moving in a different direction than how I want her to out of spite.”

“That’s my girl in there!”

“Look,” she said as she pointed to the monitor. “If I touch her here, she lifts her butt up so I can’t see anything.”

Sure enough, that's exactly what happened.

"God willing, I'll have met my match with her!"

When the technician inserted the wand to begin the internal exam, the monitor revealed a little foot trying to kick the wand out.

“Are you prepared for a child with a high aptitude?” the technician inquired. “She shouldn’t know how to do this at 18 weeks!”

I laughed out loud. “I just want her to be healthy. If she's gifted, too, even better!" (I had to take the fact that my fetus was gifted with a grain of salt.)

“Okay. She’s in the right position now,” the technician informed me. “Let’s see if we have a hamburger or a hot dog. [Pause.] There’s the hamburger! Look at the three lines.”

“Great!” I yelped, as I tried not to shake my head at the fact that a health care professional had just referred to a vagina/vulva as a hamburger and a penis as a hot dog. I think I would have preferred “hoo ha” and “ding-a-ling!”

When the technician moved on to look at cervical length, I measured in at 4.5 centimeters. That was perfectly normal at this point in my pregnancy.

I smiled to myself, thinking how different it was for me to be in a medical exam and hear words like “perfect” and “normal.” I could get used to this! During the last few measurements, I made a connection that had me in tears on the table.

“Are you okay?” the technician asked.

“Yes, I am. I just realized that January 7, 2011 was the day of my last chemotherapy-related IV. Two years later, here I am. This is wild!"

“Wow!” the technician exclaimed with surprise. “This is a miracle!”

“Yes, it is.”

My tears of joy abated, but my smile continued for the rest of the afternoon.

How did my second sonogram go?

To be continued…

December 2012

I woke up on December 6^th, exhaled and smiled. I had made it through the first trimester. I continued to meet with Dr. OB, and she recommended that I see Dr. Real Deal.

Dr. Real Deal is regarded as one of the premier maternal-fetal medicine specialists in the region. She performed the CVS test on me back in November. (Yes, she was the doctor who tried to show me a sample of my placenta up close and personal!)

In our first office visit together, Dr. Real Deal reviewed my medical history with me. She had a lot of concerns about the potential complications caused by one of my health conditions and my advanced maternal age. (Each factor individually is linked to premature births and low birth weight. The combination of the two increases the risks.)

“So, you’ll be giving birth at Georgetown?” Dr. Real Deal asked.

“Well, I’d prefer to give birth at Sibley Hospital since I’ve been going there for 13 years,” I replied.

“If you go into labor before 32 weeks, you’ll have to give birth here [at Georgetown],” she explains.

“I realize that, but I’m really hoping for a C-section at Sibley the last few days in May.”

“I don’t think you should get a C-section,” the doctor informed me as my eyes opened wide like saucers. She continued, “Your Ehlers Danlos puts you at a greater risk of bleeding during surgery. The risks would be significantly lower with a vaginal birth.”

“One of my other doctors actually recommended a C-section because of the Ehlers Danlos. And, honestly, I prefer I wasn't even awake when I give birth! I wish it was like when my mom had me. They knocked her out, and I was handed to her when she came out of recovery.”

“Well, you have to be awake medically,” Dr. Real Deal commented as I nodded. “And, with Ehlers Danlos, there’s a greater chance that you’ll need a blood transfusion. That’s another reason I’d prefer you at Georgetown. We have a better blood bank than Sibley.”

She paused before confirming that I had never received a blood transfusion before. “Hmm…you’ve had a lot a surgeries, and you never had any bleeding problems?”

“Correct.”

She continued, “Maybe you have an atypical case of Ehlers Danlos? [Pause.] Given your health history, you do seem to be atypical."

I laughed out loud and agreed with her.

“It sounds like you’re approaching this pregnancy from a place of health, rather than a place of sickness. That’s a healthier approach.” From her expression, it seemed as though my attitude surprised her.

I explained, “That’s the only way I know how to be. I’ve worked very hard at not getting emotional or stressed out over that which I can’t control. If there’s a problem, I’ll deal with it. If there’s a medical necessity for me to deliver at Georgetown or have a vaginal birth, I will. But, I’m going to continue to plan for a C-section in late May at Sibley unless something changes.”

Dr. Real Deal recommended that I get sonograms every two weeks from the beginning of January through the end of my pregnancy. She would like to make sure that the fetus is growing normally and that my cervix doesn’t grow until the proper time. From my perspective, I'll appreciate seeing that all (hopefully) continues to be going well with my pregnancy. And, if a problem arises, we'll be able to deal with it sooner, rather than later.

To some, looking at a situation realistically can be disconcerting. For me, it’s pragmatic. The "Real Deal" approach can be a good thing!

What did my January sonograms show? How am I progressing in my second trimester?

To be continued…

How long is the first trimester?

That seems like a simple question that should have a simple answer, and yet, it doesn’t. There was a time when pregnancy was regarded as a nine-month process. However, depending on when those months fall within the calendar year, nine months can be anywhere from 36-39 weeks. The average pregnancy lasts 40 weeks. For most women, that’s closer to 10 months than nine.

Another significant reason for calculating pregnancy by 40 weeks, rather than nine months, is that doctors now view the first day of your last period as the start of your pregnancy. (That removes any speculation about when a woman actually conceived.)

When I first found out that I was pregnant, I was six-and-a-half weeks along, according to the doctor’s calculations. In reality, though, the embryo was three-four weeks less than that in terms of development.

The first trimester is important from a medical perspective because most miscarriages occur within that period. At the age of 39, I had a 30% chance of a miscarriage during the first trimester. That risk would drop to 5-10% in the second trimester.

Most pregnant women wait to share the news that they’re expecting until they’ve made it through the first trimester. The first trimester technically ends after the third day of the 13^th week of pregnancy with the first day of a woman’s last period counting as day one. However, doctors and patients vary as to whether they view the end of the first trimester as week 12 (when the risk of miscarriage noticeably decreases as long as there is a strong heartbeat) or week 14.

I regarded the first trimester ending after the 13^th week of pregnancy. I waited to post the news online until I was 15 1/2 weeks. That didn’t mean that I didn’t want to share the news sooner, though.

Since I began participating on social media sites, I’ve been very open about my life in general and my health in particular. I’ve shared the good, the bad, the blessings and the heartbreak with you all.  It was incredibly tough not to write about this experience in the moment, especially since I regard many of you long-time readers as friends. But, my comfort in shouting about every major life event from the rooftop had to be tempered against my loved ones’ preference to be cautious.

Now that people know that I’m pregnant, one of the first questions I’m asked is how far along I am. When I respond in weeks, not months, most people are confused. After explaining how pregnancy is now calculated, most then inquire as to my due date.

“It’s in early June, right?”

“Well, it is,” I respond. “But, the hope is that I’ll have a C-section in late May.” (Scheduled C-sections are typically performed one week before a woman's due date.)

At the end of the day, though, whether she arrives at 39 versus 40 weeks or the exact date in which the first trimester ends isn’t that important. What matters far more to me is that I have thankfully been doing well throughout my pregnancy and she is growing as she should be. I continue to hope and pray that all continues as such.

Do you think that there’s a right time to share the news? For those of you who have been pregnant, when did you tell others?