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Today was our comprehensive anatomy scan. We had originally been booked for almost 22 weeks, but I was getting anxious to get it done so I moved it up sooner. They were able to get us in at 7:30am.
We arrived and because it was so early, there was no one really around and only one other person waiting. We were called soon after we got there. The technician this time was really nice. She said she recognized my name and she was very warm. She also explained a lot more during the scan than any of the others. She was very careful too and would tell me to close my eyes when she was near the genitals. She did well and it’s still a surprise. Baby was surprisingly cooperative this time and the scan wasn’t very long. We actually ended after about only 30 minutes. We were able to see everything and it was all normal. The placenta was good too - a big relief. She told me where I might start to feel movements in the future (right side). Baby was lying with head mostly down, hands and feet to my right side and butt to the left. Baby weighs 12 oz! We got some pictures again. It is a relief to have this ultrasound done and know that things look normal. For many people, this is the time when they feel more comfortable to share the news with others. I still have a few people to tell in person or on the phone, but I think we will announce it soon on social media. Nothing crazy, but we will definitely put it out there.
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 Today was our early anatomy scan. For an “optional” ultrasound, I was really, really looking forward to it. Again, it’s one of those moments where as a patient, I can’t imagine not having it done.
Midwife note: The early scan is done around 14-17 weeks and is an early anatomy scan. At this point in the pregnancy, not everything can be seen and is not fully formed yet. The medical purpose to this scan is to possibly identify any abnormalities sooner. Going to the waiting room, I always wonder if I’ll see someone from our practice. There wasn’t anyone. However, I did make the mistake of looking out the door into the hall. One of the genetic counselors walked by and looked in. She made eye contact with me, did a double take and backed up again to wave. I was outed! Oh well - if I was really trying to hide, I would have hidden. I spoke to her later to actually tell her the news. We were called by our ultrasound tech after 10. She was much more pleasant than the last one. Right away I told her who I was and that I didn't want to know the sex. She said okay and thanked me for letting her know. I also made sure the doctor I wanted to see was there and that he would read my scan. We started the scan and it was so big! She said the fetus is weighing in at 6 oz. It’s still so crazy to think that a fetus that size is fitting inside my small (flat, not yet showing) belly. She was very good and persistent - I think she really wanted to see everything she could. Embers wasn’t super cooperative again, but with some movements from me and the wand, she got what she needed. She was very careful around the legs/genitals and I didn’t get a peak. Embers has hands and feet, five fingers and toes. The cord insertion appears normal. The placenta is anterior and not near the cervix. Embers was moving a bit, especially the hands. The hands were right up by the face and even opening and closing. Embers was waving! Embers also liked to really jab and kick the placenta. It was really great to see. I asked her for a few extra pictures for our parents and told her the last ones we got weren’t so good. She ended up giving us 10 or so pictures! It was really great. At the end, she went to get the doctor. I hadn’t told him yet, so he was surprised and happy for me. He told me “you hid it well” and asked how long I was going to work (“to the end, right?”). He said all looked well and we’d be back in another 4ish weeks for the comprehensive anatomy scan. Overall I was really pleased with the experience. The tech was much nicer and the pics were great. I was really in awe of seeing the fetus so much and I never thought I’d felt as emotional/happy as I do. I am now waiting for movements to happen, which I know can happen later now because of my placenta. It would also be nice to start showing, but I should be grateful I haven’t gained much weight yet and can still wear my clothes, including pants. Midwife note: Anterior placenta is a variation of normal. This is when the placenta is in the front, or between the belly and the baby. It can act as sort of a pillow and muffle the fetal movements. Women with anterior placentas tend to feel movement later and often feel less movements. As the baby and uterus grow, the movements will intensify as pregnancy progresses. Today we got back from our trip to Hawaii. Because Fred just took a bunch of time off, we had to schedule the nuchal for today so he didn’t miss work again. We were home by 9:30am and really tired, so we napped before our 3:30pm appointment. I found out which doctor was on the unit that day (the perks of going to the hospital where you work) and texted her in the morning. I wrote, “are you in FEU today?” She wrote back and said “yes, see you at 3:30! :) “ I was really happy she knew already I was coming, even without me telling her. The wait time to be seen wasn’t too bad (I’ve heard otherwise at times). The tech we got was not super friendly or talkative. She barely spoke to us through the scan. It was so different than our first ultrasound. I told her my due date and she said, "well we base it on your period." I said fine and didn’t argue, knowing I would talk to the doctor afterwards to get it revised. Midwife note: An accurate due date is really important, especially for a first baby. The most accurate time to have a pregnancy dated by sonogram is around 7-8 weeks. At this time, the due date is based on your last period, but if there is a discrepancy of more than 5 days, the due date is changed. At 9-13 weeks, the due date is based on your last period, but if there is a discrepancy of more than 7 days, the due date is changed. An accurate due date is important, especially for women who go past their due dates. It can help you to avoid an early induction (the cutoff for induction is no more than 42 weeks in most cases, but often practices say even earlier like 41 weeks). The fetus was in there and now looks like a baby! Crazy! The fetus was also not very cooperative. It wouldn’t move in the right position for the nuchal. Finally she got it and it was normal. Phew. She printed us two pictures (that honestly aren’t very good). Midwife note: The nuchal fold is an area of the back of the baby's neck. This is measured as a screening for chromosomal abnormalities. In things like Trisomy 21 (Down's syndrome) the nuchal fold can be increased. It is still considered a screening and there are times where the neck fold is elevated that things are normal with the fetus. If it is elevated, further testing (like NIPT or invasive testing) are recommended. I asked that the doctor come into the room and she did. She was super friendly and awesome, as usual. We talked about the due date and showed her the first scan. She changed my due date in the system. I’m so happy because it would have been 10 full days off had we not changed it, and the new measurement wouldn’t have indicated a change from last period. Long story short, really happy we had the early scan. We left, happy with everything. We went to dinner at a place called Empanada Mama, which is an old favorite restaurant, and had a great dinner. We sent pics to our parents which they were very happy about.  Fred and I had both taken off the day since my mom was here visiting. We decided that it would be good to have the first ultrasound that day so we could have proof to tell our parents over Christmas. So we lied to my mom and told her we were working.
The tech was really nice and chatty. I told her who I was and what I did. I was really, really nervous (is the embryo in the uterus, does it have a heartbeat, is it twins). I was a bit shaky. I held Fred’s hand really, really tightly. Midwife note: A pregnancy outside of the uterus is called ectopic pregnancy. This is most commonly found in the fallopian tube. It can be very dangerous if not diagnosed early. First we saw the gestational sac. I said “thank god”. The we saw the embryo and then the heartbeat. She even played it a little for us. And just one embryo in there. Phew. I watched pretty intently. I noticed I had an ovarian cyst and I said “is that a cyst?”. I was really chatty and kind of distracted her, I think. She actually forgot to get the heart rate reading and had to do it again. Luckily the uterus is tilted up and she could do this abdominally. Midwife note: At early gestations, the ultrasound will likely need to be done transvaginally. This is because the uterus and embryo are still small and it is hard to visualize abdominally. We asked her for the extra pictures and she happily printed them for us. The ultrasound showed my EDD to be two days earlier than I calculated. I requested that the estimated due date reflect my measured results from ovulation tracking. They did this for me and I was happy about that. Two extra days makes a difference! Midwife note: A later EDD is usually preferred because of the common occurrence of going "late" or past your due date. A few extra days can make a difference at the late stages of pregnancy. It was so great to see the heartbeat and just confirm. I have no idea how people wait until 12 weeks or don’t do scans at all. I definitely understand why someone would want to go for an early ultrasound! |
ElaineA pregnant midwife living and working in New York City Archives
April 2019
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