A couple of weeks ago, I spent a good while booking in all my remaining antenatal appointments and growth scans, of which there are a scary number. Women with diabetes are offered extra scans both to monitor the growth of the baby, since macrosomia (or “big babies”) is one of the well known complications of a diabetic pregnancy. However these scans are also to monitor fetal well being and the sate of the placenta, as more seriously than being big, babies can be at increased risk of late complications including placental failure. Serious stuff, so I’m more than happy to have the extra scans for reassurance.
The problem was, by the time I tried to book the 24 week scan, they didn’t have any slots available on the same day as my 24 week antenatal appointment. Given how much time I already spend at the hospital, I wasn’t keen to have to take another half day off work, to sit in the same noisy waiting room for a second time in a week, especially because I didn’t have my 20 week anomaly scan until 21 weeks, and also had the fetal echo at 22 weeks. It seemed like a lot of scans in a very short space of time. The anomaly scan had thrown up no size concerns, (or any concerns, fortunately) and the risks of late pregnancy aren’t really applicable at 24 weeks, added to which the 24 week scan is a new addition (and still not offered in many places) to the scan schedule. So I felt confident in deciding not to have it.
This is the modern NHS. I’m entitled to consent or not, as he case may be, to any kind of test or intervention. If I decided that I didn’t want any antenatal care, no one can force me. But hospital receptionists can’t be expected to get involved in those decisions, so when they’re faced with an order to book certain appointments and the patient standing in front of them says they only want to book some of them, it puts them in an awkward position. So I understood when the receptionist sloped off to speak to the consultant.
Whilst she was gone, I started to feel like a bit of a lemon. There was a big queue building up behind me, with heavily pregnant women tutting and moaning that they needed to book in for their scans and wanted to sit down. I felt like the person in the supermarket queue who insists on counting out exact money from a pile of copper change. I began to wonder if I was being foolish, and thought of all the women who’d love another opportunity to see their baby again since the standard scan protocol on the NHS in most areas includes only the 12 week dating scan and 20 week anomaly scan. But eventually she returned saying that the consultant said that was fine as so I proceeded to book the 28, 32 and 36 weeks scans, all the while feeling the stares of the waiting queue who had by now realised that I, with my relatively smaller bump, was the cause of the hold up.
Since then it’s nagged on my mind a couple of times. I wondered if the lack of a baseline growth measurement at 24 weeks would make it hard to really assess how the baby was growing. Would it, I questioned, make it more likely for them to think I was having a big baby because of diabetes, rather than just because I was destined for a big baby (assuming the baby is big at all, of course). I have a huge fear of being judged if my baby turns out to be in the upper regions of the centile charts because I think people will assume I didn’t work hard enough on my blood glucose control, even though I know I’ve done the very best that I can. I worry too much what other people think of me.
When I arrived at my antenatal appointment yesterday, my usual specialist midwife was away.The replacement questioned why I wasn’t having a scan that day, and I explained.
“It would be best to have the scan” she said. “Just so we know what’s going on. Let me see what I can do” she added, disappearing.
She returned a few minutes later with a piece of paper “There is a cancellation at 12.30, so we can fit it in today”.
I almost bit her hand off in my rush to accept it!
After my appointment was over, I wandered outside to call Ian. It only occurred to me at that point that this was the first scan that he wouldn’t be present for. I felt a bit sad for him, but he assured me that of course it didn’t matter and that the only thing that was important was that the scan showed a healthy little Flangelina. I headed back inside to kill time with a sandwich and finally it was time for the ritual couch positioning, dimmed lights and warm jelly on my ever expanding belly.
The sonographer performing the scan was perhaps the loveliest so far. She explained a number of things, pointing out features and capturing a cute picture of two tiny little feet, with all the toes visible. She took a while carefully taking all the measurements and then complimented me n how well I must be controlling things.
“It must be difficult, having diabetes and being pregnant” she said “But you’re obviously doing a great job as baby looks absolutely fine. Measuring right on target”
And sure enough, when I looked at the little charts they print to put in the notes, all the measurements are hovering around the 50th centile. The Abdominal circumference of only marginally higher, and the femur length a bit shorter. Sounds like Flangelina will have my shape then!
It was wonderful to spy on our kid again, but even more wonderful to know that he or she is growing just fine in there.
Keep it up little one, and Mummy will keep working hard to make sure that I don’t feed you too much sugar. You’re quite sweet enough!