Just when you think you’ve managed to swim in a new sea and its cycles, a wave comes from behind at lowtide, leaving you gasping.
As an official “high-risk” obstetrics patient, I’ve been put on a regimen of checkups with special features – ultrasound exams every 4 weeks, to check on both baby (presumed by mommy to be fine) and cervix for signs of early labor. From 16 to 28 weeks, Little one’s growth rate has been dropping. I’ve been asking why, and have been advised to increase protein intake, reminded not to smoke (not an issue) and to keep healthy. Measured in percentiles, she’s gone from 78th to 32nd in 12 weeks – a full quartile in the past 4 weeks alone. This was a tear-inducing shock. Not to mention a complete reversal of experience I had with my first, who maintained a 95th percentile size and still is near the top of his development curve four years later.
At the OB’s instructions, I have been protein loading until the cows come home, and even then, I hit them up for a pail of milk. I’ve been feeling bigger, and thought for sure we’d at least maintain her growth rate (90g or protein a day, minimum; dropping the OB-sanctioned coffee and white-knuckling my way through the days of migraine). But the sonographer said 32nd %ile for weight, and I gasped.
“She was 58th at my last exam.”
I had brought a chart I made from the last three ultrasound reports, showing the downward trends. I had noted that the placenta was evaluated at Grade 2 at 20 weeks – about 10 weeks too soon for such a grading. I had a list of questions, and now I had tears to blink back. H held my hand while I looked at the twinkling lights in the ceiling (all ob/gyn practices should consider such features for their examining rooms…)
The MD I had this time, my third in 5 visits, was the one who delivered my son in an emergency c-section, and he must have remembered what we were like – as he showed up with a set of charts for us. He explained that we were still in a safe spot, and went through each of the measurements, explaining to us what he looked for in terms of trendlines and when they saw a red flag. He explained the ratios and relationships they watch closely, and the range of error with ultrasound readings – up to 10% on weight, and even more on percentiles for abdominal circumference.
He told me that maybe the baby was figuring out where she wanted to be – petite and powerful, perhaps, based on her activity level. He told us what would happen if she took a big drop at the next exam, and what the next steps would be, including increased exams to determine if there was a particular issue getting in the way of baby’s growth, and the issue of discussing how early to deliver.
He told us that if there was a problem with the placenta, there would be little we could do to override that, save to keep the same high-protein, high-nutrition diet to get as much to the baby as possible.
He also told me I could come back at any time, regardless of appointment. “Just show up if you’re worried. We’ll take you.” It was kind and reassuring.
But on the way home, I couldn’t help but wonder, “What if what she wanted to be was a brief visitor? What if she decided this wasn’t the time or place for her to arrive?” I’m still wondering.