Stef Woods

Why Did I Start to Cry during My 18-Week Sonogram?

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…

Dr. Real Deal

December 2012

I woke up on December 6th, 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…

The First Trimester

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 13th 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 13th 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?

Looking for Another Word

Both my friend and I were diagnosed with early-stage breast cancer in 2010. We followed our doctors’ recommendations regarding surgery and treatment to a tee. In 2011, we both rejoiced over the scans that showed we were cancer-free. We had beaten breast cancer! We were survivors!

For over a year, I had worn the survivor badge with pride. I earned it after all, didn’t I?

As I became more active with the online breast cancer community, I noticed that many of the advocates I admire didn’t use the word, “survivor,” when referring to themselves. The documentary, Pink Ribbons Inc., provided some clarity regarding these women’s decision not to embrace survivorship.

In her review of the film, Brenda Sabo explains:

The cultural norm within pink ribbon implies that if one complies with treatment, if one battles hard enough or if one is strong enough cancer can be beaten. In essence, the message emerging from the promotion fails to achieve a balance between hope, understanding and the reality of breast cancer — it kills up to 59,000 women in North America every year.

For women with advanced disease the message is about personal failure, of losing the battle. As one woman stated, “You can die in a perfectly healed state.” Survivorship is a label, an unintended put-down of women and men who don’t survive, who were unable to beat the disease.

Advanced breast cancer, also referred to as Stage IV or metastatic, means that the cancer has spread beyond the breast and lymph nodes into an organ. Women who have Stage IV breast cancer have a 15% chance of survival after five years. Thirty percent of women with early-stage breast cancer will develop metastatic breast cancer. Despite those statistics, only 2% of the budget for breast cancer research goes to research to benefit patients with metastatic breast cancer.

Lately, I’ve been thinking a lot about Stage IV breast cancer. My friend is no longer in remission. Her breast cancer has returned and is now in her lungs and bones. She was told to get her affairs in order.

I pray for a miracle for her and for all those who are battling terminal illnesses. I pray for the day when there is a cure, and everyone can be a “survivor.” Until that day, though, I’m looking for another word.

Any suggestions?

Is It Safe to Blow Air Deeply into the Vagina?

Are there any sexual restrictions during pregnancy?

Dr. OB posed that question to the expectant moms in attendance during the mandatory first trimester class.

The answer?

Pregnant women should feel comfortable having sex as much as they want during pregnancy. Sexual activity won’t hurt the baby-to-be since the uterine muscles and amniotic fluid protect the fetus. Sex and orgasms also do not increase contractions or the risk of premature labor.

It’s normal for parents-to-be to feel hesitant about having sex. In addition, women who are ill during pregnancy typically won't want to have sex. If your sex life has noticeably changed, make sure that you communicate with your partner, prioritize intimacy and seek out alternative ways to show affection.

Dr. OB continued by stating that,

Blowing very hard into the vagina may cause an embolism and possibly death so don’t do that during pregnancy. Normal breathing during oral sex is fine, though.

All of us in the class looked at each other with confusion, wondering what that entails or who actually does that.

Upon arriving home from the class, I wanted to know more. According to The Mayo Clinic and Cosmopolitan, blood vessels in the pelvic region are more pronounced during pregnancy and menstruation. Deeply blowing air into the vagina could cause air bubbles to form and those bubbles can block a blood vessel. If that blood vessel leads to the heart or the brain, serious complications, including death, can ensue.

Are there any additional restrictions?

As pregnancy progresses, women will be more limited in terms of how they can position themselves during sex. Communication and creativity will be critical to finding positions that are comfortable.

The Mayo Clinic doesn’t recommend anal sex during pregnancy, given the possible transfer of bacteria. Check with your doctor to find out more about that and other restrictions. If you're not comfortable talking to your doctor about sex, read my tips for doing so!

Your doctor may also add restrictions if there are health concerns during the pregnancy. For your sake and the sake of your baby-to-be, adhere to them! It’s also worth being as specific as possible with your questions so the doctor can provide you with specific guidelines.

So, dear readers, I’m curious. Has anyone tried the “Huff and Puff?” For those of you who have been or are pregnant, did your sex life change? 

I’m Not Fat; I’m Pregnant!

I’m halfway through my pregnancy this week, and quite a few friends have commented that I don’t look pregnant.

Do I regard those remarks as compliments? Of course! However, I take them with a grain of salt. The time will come in the not-so-distant future when I won’t be able to hide the fact that I’m pregnant and my regular clothes will no longer fit.

It's simultaneously fascinating and disheartening how preoccupied women are with their weight during and after pregnancy. I wish that our culture put greater emphasis on what’s important. The average baby is 20 inches in length and weighs between six and nine pounds. How can women expect that their bodies won’t change dramatically during that process? Isn’t it far more important that the mother-to-be and baby-to-be are healthy than the number on the scale?

Any friend of mine who has given birth knows exactly how many pounds she gained during her pregnancy and how long it took her to lose the weight or how much weight she has left to lose. New mothers typically are juggling 20 balls in the air at any given time. Why add unnecessary pressure about weight into the mix? At a minimum, doctors believe that it should take a woman as much time to lose pregnancy weight as it did to gain. That unfortunately doesn't happen overnight.

Our society’s preoccupation with weight also extends to how we treat people who are heavier. We should regard insults and judgment about obesity as unacceptable, and yet, those remarks are often either encouraged or condoned. In an essay by Harriet Brown in The New York Times, she writes:

I’ve sat in meetings with colleagues who wouldn’t dream of disparaging anyone’s color, sex, economic status or general attractiveness, yet feel free to comment witheringly on a person’s weight.

How does that issue relate to pregnant women’s views on their own weight? Well, for many, it thankfully doesn’t. For others, though, the issues are unfortunately related.

I found this abohorrent t-shirt online. If you conduct a broader search, you’ll see that there are many similar shirts, buttons and a book using the same phrase.

How is this not regarded as prejudicial? Why would anyone tolerate the casual use of such expression, let alone buy a product that contains such a disgraceful phrase?

One pregnant woman’s concern or frustration about her weight is her prerogative. However, that concern or frustration should not be at the expense of another woman. May one day I live in a society in which that hope is a reality.

What are your thoughts on the t-shirt? Have you heard this expression or seen anyone wearing these products? How did you respond? 

A Little (or a Lot of) Respect

According to the US Census, 44.6% of women between the ages of 15 and 44 are childless. Nearly half of those women who earn $100,000 or more do not have children. When I think of my five closest friends, 80% are childfree.

I’d like to believe that we live in an age in which all women’s choices can be respected, yet I realize that viewpoint is rather idealistic. There is still the presumption that heterosexual women should get married and have children – in that order. For some women, that is the path of their choosing, while for others, it isn’t.  I hope for the day when being single after 35 or married without a child doesn’t evoke confusion or judgment.

I’ve been thinking a lot lately about women’s choices and the need to respect the spectrum of options regarding relationships and family. As excited as I am to be expecting, I approach pregnancy with more pragmatism than sentimentality.  I attribute that approach to a combination of my age and health experiences.

How have I approached pregnancy thus far?

"+1:" When friends ask how the three of us are doing, I respond as follows:

The Man, Flake [my dog] and I are great! Thanks!

I smile when friends refer to their babies-to-be as their “+1s” or any fraction thereof. But, I feel more comfortable saving the use of the term, “+1,” until she’s here. I’m thankful that she’s growing as she should be, but if she doesn’t keep growing inside of me, she can’t survive outside of me.

Sonogram Photographs: If you’re a regular reader, you know a lot about me. (At times, you might have found out far more than you’d like to know!) However, I won’t be sharing any sonogram photographs or as I refer to them, “placenta pics.” In the early stages of pregnancy, I think that the baby-to-be looks like a tadpole. In the latter stages, 3-D and 4-D technology creates some images that I find to be off putting.

“Mommy” and the Baby’s Name: I look forward to being a mom in four-and-a-half months, but I don’t feel comfortable when people call me “Mommy.” Likewise, although we’ve picked out a name, we’re not sharing that with anyone until after she’s born. (I appreciate that this pregnancy is a miracle, but I don’t want to tempt fate!)

Shopping for the Baby: I’m halfway through my pregnancy this week and haven’t bought one piece of baby clothing or any items for the nursery yet. I’ve said that I won’t begin to shop until she’s 24 weeks since that’s the stage at which she’s potentially viable. (Again, I’m not tempting fate!) In addition, there’s such excess when it comes to baby products. The world will go on if I don’t have a Diaper Genie or the perfect wallpaper trim when we come home from the hospital. I can’t get overwhelmed about the small stuff.

Online Resources: Once a week, I go onto one pregnancy website for a few minutes to read what's going on with my body and the fetus. Beyond that, I have neither the time nor the inclination to be inundated with information about my pregnancy. If my doctor says that all is going well and I feel good, I say a prayer of thanks and hope for more of the same at my next appointment.

I appreciate that I’m in the minority as to how I view being pregnant, and I would never tell someone else how to react to the experience. I’ll continue to respect whatever choices my friends make, regardless of which boxes they check off on a census form or how they view pregnancy and motherhood. At the end of the day, I  hope and pray that my friends are happy and healthy, and I'm thankful that they hope the same for me.

It’s a…?

November 19, 2012

I had chosen to have CVS testing at 11 weeks to determine whether the fetus had any chromosomal abnormalities. Since the test results analyze all 46 chromosomes, the genetic counselor asked if I wanted to know my baby's gender.

There are varying opinions about finding out the gender before giving birth. I’m of the mindset that I’d like to know as much as I can as soon as possible. I also have never been one for surprises, let alone big surprises! I told the counselor that I wanted to know the gender, provided that the fetus didn't test positive for Down’s syndrome or another chromosomal abnormality.

Several friends had asked me if I thought I knew the gender. I guessed that it was a boy because of the old wives’ tales that women who don’t have morning sickness and crave more salt than sugar are having boys.

The genetic counselor indicated that she would call me with the results on Monday, November 19th in the late afternoon.

On Monday at 3:30pm, my cell phone vibrated, while I was driving home. I recognized the Georgetown extension and pulled over into a parking lot so I could safely answer the phone.

“Hi Stef,” the counselor said. “I’m calling with some good news.”

“Really?” I responded hopefully, but with a touch of nervousness.

“The initial results came back, and there are no abnormalities. The results are 99.96% accurate. It will take another week to get the full 100% results, but you can breathe easy now.”

Tears filled my eyes as I exclaimed, “That’s great news!”

The counselor then asked, “Do you still want to know the gender?”

“Yes.”

“It’s a girl.”

“Would you mind saying that again?” I inquired as tears streamed down my cheeks.

“It’s a girl.”

I began to cry so hard that I was shaking in my car.

“Wow. This is real now. Really real. Thank you,” I said before we discussed the next steps.

When I hung up the phone a few minutes later, I sat in my car with a huge smile on my face as I continued to sob.

I had always imagined that I would adopt a little girl. In August 2010, shortly before I headed into my first surgery to remove my tumor, one of my best friends recommended that I picture my dog for peace and motivation. As I was going under, my subconscious didn’t just visualize Flake. I also pictured a little girl. I couldn’t see her face, but I could see her short ponytail, white cardigan and pink dress.

I had thought I knew how this little girl would come into my life, but God had a different plan. I spent the rest of the night with a huge smile on my face and tears in my eyes as I counted my blessings.

Did knowing the gender make me more sentimental about my pregnancy? How did I feel about other people’s excitement about my news?

To be continued… 

PS What are your thoughts about finding out the gender?