A Date With the Dildo-Cam

One of the necessary evils of fertility treatment is the transvaginal ultrasound. Otherwise known as the dildo-cam. You know, an ultrasound wand shaped like a dildo that gets inserted… Well, I don’t really need to spell it out, do I?

Today was my fourth meeting with the wand-of-doom in this cycle. Taking my knickers off in front of strangers is becoming a reflex (that I need to keep in check, obviously).

The first appointment was a pre-treatment scan which brought me the news that my ovaries looked “lovely” and I had one of the neatest caesarean scars the sonographer had ever seen. I call that good news.

The second scan was my so-called “baseline” scan, carried out on the second day of my cycle to check that the lining of my uterus was sufficiently thin and that my ovaries were nice a quiet, ready to be stimulated to produce lots of eggs. The observant (females) amongst you will have noticed the first problem with this scan. The day two part. And no, there isn’t room up there for the dildo-cam and a tampon.

Yes, it’s icky.

Yes, you leave your dignity at the door when you sign up for IVF.

Ho hum.

The second problem with this scan for me was the results. Far from being “quiet” and despite a month on medication that! amongst other things, was supposed to suppress any cysts, I had a large cyst on my left ovary. This is the first time In all of the gynaecological scans I’ve had in the last 15 or so years that I’ve had a cyst on my ovaries. Talk about timing. And to add to the insult, my right ovary decided to hide behind my uterus where it couldn’t be seen.

I had two options to deal with the cyst. One involved delaying treatment, the other didn’t. Unfortunately the option which didn’t involve delaying did involve another date with the dildo-cam, a large needle and a not insignificant amount of pain.

I took that option.glutton for punishment or just really desperate to have another child? I’ll let you work that one out.

So the following day I found myself with legs in stirrups (again) whilst shaking the hand of our lovely consultant (relieved that it was him doing the procedure, because that’s an awkward way to meet someone for the first time!)

I can honestly say that having a cyst drained with no anaesthetic was one of the most acutely painful moments of my life, but fortunately it was extremely short lived. I was invited to watch the needle sliding up in to my ovary on the ultrasound screen, by way of distraction, but I had eyes screwed tight shut before it had even come in to view!

That was a week ago. Since then I’ve been shooting up like a…  well, like a diabetic, only less often, taking the drugs to stimulate my ovaries to grow lots of eggs. Today I had another date with the dildo-cam to see how I’m getting on.

And this week the news was good. The cyst hasn’t returned, both ovaries were easy to find and I’ve got almost twenty follicles, with many already of a good size. All of which means we’re on target to collect eggs next week and should get a good haul of 12-15.

I have another scan on Friday and then, all being well, my final meeting with the ultrasound wand will be in theatre as I have my eggs collected. One thing is for sure, it’s absolutely nothing like what’s involved in conceiving a baby the traditional way.

And I know which I prefer!

36 Week Appointment

I don’t feel like things went very well at the hospital this morning. Maybe my expectations are out of whack, or maybe it’s just all the hormones, but yet again there were a lot of tears.

Things didn’t actually start out too badly. In fact, they started out rather well. My fourth (and hopefully final) growth scan revealed a baby that not only looks completely healthy, but looks a very average size. This is complete contrast to the 28 week  and 32 week scans, which had suggested that they were turning in to a little chubster. I can’t help it; I still see the size of the baby as a measure of my success or failure at pregnancy. So hearing that they are sitting right around the 50th centile, with only a slightly increased abdominal circumference is naturally welcome news.

The less good part of the scan was the re-assessment of the placenta. Back at my 20 week scan  it was noted that the placenta was lying low in my uterus. It wasn’t completely covering the cervix, but a concern was raised about whether it would prevent a vaginal delivery. At the last couple of scans, the sonographers have said that things looked fine, and to be honest it had gone out of my mind. When it came up again today, I instantly panicked that this would be the unforeseen end to my desire for a natural birth.  And then, I was further disappointed that, having made it this far in pregnancy without a single internal ultrasound (with the dildo-cam) the sonographer apologetically informed me that the only way to get a conclusive measurement of the distance of the placenta from the cervix was to go in from the bottom. Cue lots of panic that my bikini line has not yet been prepared for B-Day, and since I can’t see it, I was horrified about what she may be about to witness. Thank goodness for discreet, unflappable sonographers. And thank goodness that after all that, the placenta was in a good position and I was signed off for vaginal delivery.

Things went properly downhill, though, when I went in to see the obstetrician. Bear in mind that I’ve always understood that the hospital (and general diabetes in pregnancy) policy is induction at 38 weeks. Although I’ve agonised a bit about this, mainly because of my desire to avoid an epidural.  I have come around to the idea in order to make sure we end this journey with a healthy baby. (The fact that I’m gettting impatient to meet our baby helps too.) I’ll be 38 weeks in two weeks time, so I was fully expecting to actually make some plans today about when I would come in and how things would progress. I’d gone to the appointment armed with my birth preferences and a list of questions that I wanted to discuss.

But everything got off on entirely the wrong foot when the obstetrician sort of dismissed the scan results and told me not to place too much importance on them. Removed from the situation, I can rationlise that she didn’t mean to be nasty or dismissive of what I was regarding as potentially an achievement. I know she was giving me exactly the same line that she did when the scans gave less favourable results, and I know that she is right that today’s scan could be the misleading one. But irrespective of all that, her dismissal left me feeling utterly deflated and wondering just why I’d been going through these scans. Before I knew it, the tears were on.

It went from bad to worse, as my questions were glossed over. I think my previous deliberations about induction might have been misinterpreted as me definitely not wanting to go for it, because there was no discussion at all of booking a date, just that we’d review it next time. Again, with hindsight I can sort of see this positively, because it means they have no concerns and are willing to let me go a bit beyond that. But at this stage, I really want some clearer idea of what is going to happen. Delivery is no longer too distant to think about. I’ll reach full term between this appointment and the next and it’s possible that I may not even make it to the next appointment. The baby could be here before that.

Some of the things that we did get to discuss were met with unsurprising answers. Like being told that yes, I will be pretty much confined to the bed throughout induction, and there is no hope of me getting anywhere near a birth pool even if I go in to spontaneous labour. I don’t have the fight in me to debate these points. My obstetrician seems to firmly believe that I will opt for an epidural when I’m actually in labour, which just cements my belief that no one really understand quite how much of a fear this is for me.

The biggest chunk of the appointment, though, was devoted to a stand off about something in which I do really passionately believe: my right to take care of my own blood sugars for as long as I feel able during labour. It’s something about which I won’t back down.

I’ve had bad experiences before in hospitals, where non-specialist staff do not understand the first thing about diabetes. Even something as elementary as the importance of uninterrupted insulin supply for a type 1. I could go in to details about the time an IV insulin infusion failed at night and the staff told me replacement was not a priority until morning, 8 hours later. EIGHT hours with no insulin could, likely would, have put me in to DKA. Long and multiple stories short: I don’t trust other people to do it anywhere near as well as I can. I don’t want to transfer to an IV sliding scale just as a matter of course, because I know they can be prone to failure in my rubbish veins, and I will be left with the problem of transitioning back afterwards.

I’ve worked so hard on my control since before I fell pregnant. I’m not letting go right at the end. All I really want is for Ian and I to be in control, including the ability to say “actually, we don’t want to be in control now, so please take over and put up an IV sliding scale”. I didn’t expect this to be a problematic point. I thought the team knew me well enough, knew what a control freak I am, how important this is to me and how well I can do it. I thought I’d proved all of that. But what I was met with was that it was “inappropriate”. That I had to “learn to be a patient and let go”. And that I couldn’t ask Ian to help me, never mind that he wants to, because it’s such a massive part of our everyday relationship. He’s happy, at this point, to know he’ll have a definite way in which he can help me during labour. And if it all goes pear shaped and we can’t do it on the day, then we’ll say so. It’s not as though we have to commit to what will happen right now.

My tears were a mixture of frustration and downright anger.

I have no control over where or how I give birth. I’ve accepted that the process needs to be medicalised to degree to keep me and the baby safe. This is the one thing – ONE THING – that I want to be in control of. I can’t understand why that is being denied to me. I understand that I’ve never been in labour before and that I might find that when it comes to it, I don’t want to be worrying about diabetes. What I’m asking for is the space to make that decision at the time, when I am in labour and I do know how I feel.

The appointment stalled around this point. I had more questions, although I can’t really remember them now. Mainly about what will happen after the birth. But I was too worked up to go on. I felt as though I was being treated like a silly, naive little girl who knew nothing about what she was discussing. When the obstetrician asked to see the piece of paper I’d scribbled my notes on, something snapped internally. I told her I’d asked them all, even though it wasn’t true. Because suddenly I don’t want to do it their way. I don’t care about the answers to those questions, because I’m determined to try and makes the answers be what suits me. I absolutely DON’T want to sacrifice the health and safety of my baby. But that, ironically, is exactly why I don’t want to relinquish my diabetes control.

I was so angry when I walked away that I almost wanted to hire an independent midwife who’d be prepared to work with me for a home birth, ridiculous as that sounds. But having realised how much nobody wants to listen to and work with me, I suddenly felt very lost. I’ve not felt frightened of labour at all during this pregnancy and I’m still not frightened of labour itself. But I am petrified of how I will be treated. I can envisage clearly now how I’ll be dehumanised and treated as a medical entity. A problem. A number.

Is it really too much to ask to be treated as an individual, rather than simply a “pregnant diabetic”.

I haven’t put a question mark to that question, because after today I feel like the answer is definitive. And it’s yes.

I’m not sure where to go from here. I thought I’d have an induction date planned. I have an appointment in two weeks, where I’ll probably be given a sweep. I wouldn’t really turn my back on hospital care, because I do know it’s the safest and best place for me to be. But I feel so let down. So misunderstood. So disrespected.

So no, things did not go well at all at the hospital today. But all I can do is keep waiting and keep refreshing my resolve that when it comes to it, I’ll stand up for myself and for my unborn baby. I will do what is truly best for us, not what is best for the hospital staff.

Thirty Two

Thirty-two weeks pregnant. Holy cow, I’m getting close to the finish line – four fifths done. And holy cow, I’m getting big. I can’t remember what my feet look like and putting shoes on is a massive struggle that adds several minutes to the time taken to leave the house.

This morning was a busy morning. I had the 32 week growth scan, followed by an antenatal clinic (ANC) appointment, and then my third trimester eye dilation and retinal photographs. It didn’t start out well when I found myself waiting first ten minutes, then twenty minutes past the time of my scan appointment. Then I reached the time I was due to be in antenatal clinic. Fortunately the two clinics are adjoining and do actually speak to one another, so I was assured they wouldn’t fail to see me in ANC. By the time I was called in to my scan though, I’d worked myself up in anticipation, and because I was worrying about getting away from the hospital to make my eye screening appointment.

The sonographer performing the scan was the same one who did my 28 week scan. She complimented me again on the fact that I must be taking good care of myself. But I could hardly bear to ask just how big my big baby had got.

When I looked at the print out of the scan measurements, I couldn’t suppress my tears. The abdominal circumference measurement is now above the 95th centile – even higher than it was before. And it’s the abdominal circumference that suggests a diabetes-induced big, fat baby. Fair enough, it’s not that far out of proportion of all the other measurements. (Except femur length – Flangelina obviously has short legs. Like their Mum.) And the estimated fetal weight is only at about the 65th percentile, but I feel like such a failure and there really is nothing more to say.

When I made it around to the antenatal clinic, I was stressed out enough that my blood pressure had climbed to a ridiculous 140/95. Which sent me in to a panic about pregnancy induced hypertension and pre-eclampsia . My obstetrician firstly reassured me that it was only a blip because I was worked up and she wasn’t concerned, plus there was no protein in my urine. Then she tried to move straight past the numbers in the scan report. She reminded me that scans are not totally accurate, a problem that may be accentuated by having the same sonographer do two consecutive measurements, as their bias in reading the values may be higher. She trotted out the old line about how I am doing such much more, and so much better than all their other patients. How the effort I am putting in, and the results I am getting out, are second to none. How it’s “normal” and “common” to see these kind of increases in babies of diabetic mums, and how they still turn out healthy and OK. But I don’t care about anyone else, or their babies. I care about my own pregnancy concluding safely. I don’t want to have a “normal diabetic” pregnancy. I want a “normal normal” pregnancy. I felt frustrated and resentful and noting was going to get me out of that funk.

I was a hormonal, tearful mess. And like I do, I descended in to panic about everything. Suddenly I couldn’t cope with the whole diabetic pregnancy a moment longer and wanted to be the same as all the carefree women in the waiting room receiving happy news from their scans and appointments. Of course, there were bound to be women there receiving far worse news than me with my little fatty. And after a ten minute melt down, I realised it, and remembered to thankful that nobody was suggesting that Flangelina is not healthy. Just big. And big is not necessarily bad.

We managed to discuss, through more tears, my fear of spinal anaesthesia and hence of a c-section. I’ve been waiting for several weeks now for an appointment to see a consultant anaesthetist to really discuss these fears, and whether they are founded. I’m beginning to panic that it won’t come through and I’ll be in established labour before I get to talk about it. The reassurance here was more concrete, as they called through to the consultant’s secretary to confirm that I was in the system, and an appointment will apparently be with me shortly.

We also discussed a bit about antenatal collection of colostrum and fortunately the reaction was very positive. I was, however, advised that I needed to wait until 37 week because of the risk that nipple stimulation would cause labour. Having Googled the topic, I’m sceptical in the least about this statemet, and I’m sure my body would only go in to labour if it were ready to. But since I need sterile syringes from the hospital to collect the colostrum in, I’ll have to stick with them on this. The amount that is leaking out, I don’t think I’ll have a problem collecting enough in just a couple of days.

Despite the lateness, and all the tears, I made it to my eye screening on time. They never give anything away whilst your there, but everything has been fine up until this point. I have enough else going on, so I’m not going to dwell on the possibility of something cropping up in my eyes. I am just very glad that I’m now on maternity leave, as there is no way I could have gone back to work with my red-rimmed and hugely dilated, blurry eyes – a combination of crying and dilation for the retinal photographs.

So, what now? Keep working at it I guess. If the baby is already fat I can’t make it actually slim down in utero, but I guess I can try to stop it gaining too much more weight. I have no idea how, because I really feel like I’m doing all that I can. But I suppose I just have to do even more.

My Big Baby

Today’s 28 week growth scan brought mixed news.

The Good: Flangelina has turned. The belly rumbling and rolling that I felt this weekend was obviously the outward manifestation of their internal gymnastics, because Flangelina is now hanging out upside down like a bat, and pretty low down in there. This is a big relief as it’s one hurdle that would reduce the chances of a natural delivery out of the way. So long as they stay that way of course. But I’m keeping up with birth ball bouncing and swimming to encourage that, and I feel much more confident about them not being breech than I did before.

So, yay!

But…

The Not So Good: Flangelina is beefing up in there.

It’s not catastrophic. In fact, the sonographer commented on how well I must be controlling my blood sugars as she was writing up the data. She said I was doing really well and the baby looked great. She then casually, as if it was no big deal, added that the baby’s abdominal circumference had jumped up to the 80th centile.

And I lost it. Started crying big, fat silly tears. Because last time everything was measuring right around the 50th centile. And when a baby gets big because of diabetes, it is invariably the abdominal circumference that enlarges ahead of the curve since that is where the extra fat gets laid down. In other words I’m not simply growing a larger than average baby. I’m growing a little fat baby.

Instantly I felt like a failure.

But I also felt frustrated. Because I don’t know what else I can realistically do. I’m wearing the DexCom full time and testing 10 or more times per day in addition. I’m carb counting like a pro and pre-bolusing where I can. I’m getting as much physical activity as I can and generally working hard. For the most part, I’m seeing excellent results. The DexCom tells me that I’m inside my tight target range of 3.9 – 6.8 more than 70% of the time. And a large chunk of the remaining time I’m actually spending too low, which whilst not ideal for me, won’t be packing the pounds on Flangelina. These are numbers that are nearer to normal than I’ve even been since I was diagnosed as a small child, and it’s frustrating to think that they still aren’t good enough.

Both my obstetrician and diabetes specialist nurse did their best to reassure me. Scans are not that accurate. The numbers say that I am doing fine. Big babies are not unhealthy, they just may be a bit more difficult to deliver, and all the evidence points towards higher birth weights actually being healthier in the long run. They were at pains to point out how much more seriously I take this than the majority of their patients, and how the results really reflect that. HbA1c’s of less than 5 aren’t common, apparently.

I don’t really care how much better I’m doing than other people though, if it still isn’t good enough. If others choose not to take it seriously, that is their problem and it doesn’t mean that I can justify doing the same. My health and my baby are what matters to me. And I’m still worried. I can’t help but think it’s just a sign that I’m not as on top of things as I thought. I’m afraid that it means failure of the placenta is more likely. And that caesarean delivery is more likely. I feel like my body is failing my baby. I’m failing my baby by not being successful enough at keeping my body in check. I’m not minimising the risk of problems.

Flangelina will have their whole life to hate me for the things I do (or don’t do) to embarrass them. But I don’t want them to have reason to resent me already. And, if I’m honest, I don’t want other people to have reason to point the finger at me and say that I couldn’t keep my baby safe in the womb.

I suppose I need to re-focus. I need to avoid the tendency to complacency that such a low A1c and steady CGM graphs have given me. Nothing can be taken for granted.

It wasn’t all doom and gloom though….

The Fun: We told the sonographer that we’d been for a private 4d scan. Not to be outdone she exclaimed “Oh yes, we can do that with this machine”. In an instant the grainy 2d image on the screen had flipped to a moving three dimensional picture and we enjoyed several minutes of indulgent baby-gazing.

Flangelina is beautiful, that’s for sure. Every chunky inch of him or her.

I’m sorry, baby, that I’m feeding you a diet of sweeties. I promise to make it up to you when you’re born.

In Four Dimensions

I’ve already had quite a few scans in this pregnancy, and I have at least 3 more “Growth and Fetal Wellbeing” scans to come. I know, purely from reading parenting and pregnancy forums, that a lot of women would give their eye teeth for these extra glimpses of their unborn baby and reassurances that everything is progressing as it should.

The thing is, I’d actually prefer not to need so many extra scans. I’d prefer to be having a low risk pregnancy without the constant worry of how big the baby is getting and whether my placenta is showing signs that it won’t make the finish line. Each time I’m booked in for a scan, I’m worrying about what they might, or might not, find. It’s full of tension, and it reminds me how medicalised this creating new life process has been for me.

All of which is part of the reason that we decided to book in for an additional, private, scan: A 4D Scan to be precise. Sometimes Ian and I lose sight of the fact that we’re parents-to-be. We forget that we should be enjoying this time, and our last months as a couple before we welcome our precious bundle in to our family. So we decided to have a scan that was purely for our enjoyment, with no measurements or assessments, just watching our baby swimming around in their little watery hidey-hole, and checking out what they look like right now.

I did some online research and we eventually elected to book the scan in Canterbury. It’s a bit of drive from home, but the package was a very reasonable one in terms of what was included for the price, and Ian had never been to Canterbury before so we figured we’d make a bit of a day out of it. When we set off bright and early this morning I had none of the usual anticipatory fear that I feel before a scan. Instead I was excited about seeing Flangelina in a new light. Wondering what they’d be up to in there, whether they would hide from us or show their face readily, whether they’d be turning somersaults or sucking their thumb.

Playing with the cord
Playing with the umbilical cord and scratching their head

For once the kid was not shy, showing us their full face and turning to give us a better view. We watched as they played with their umbilical cord. We watched them wave their hands across their face and then bring their feet right up to kick themselves in the forehead, feet stretched right above their head. Damn I wish I was that flexible.

Oww... just kicked myself in the head
Feet up by their head... I wish I was this flexible

Flangelina definitely has my lips, but I think I can spy Ian’s nose. We didn’t get to see the ears, so no clues as to whether they may have inherited my mouse ears, or Ian’s long ears, and definitely no idea whether they stick out or not! I do still think Flangelina is a boy though, based on the fact that I think its face looks sort of boyish!

I'm getting kind of squashed in here!

For half an hour Ian and I were captivated, ohhing and ahhing at the antics of our baby as they unfolded on the scream. And for half an hour we felt like ordinary, excited parents-to-be in a world where blood sugars and carb counts, abdominal circumferences and estimated weights didn’t matter.

It was awesome.

 

Who are you looking at?

Surprise Scan

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!

Fetal Echo

The fetal echocardiogram, a detailed scan of the baby’s heart, is not a routine scan for pregnant women in the UK. But my combination of health conditions (specifically type 1 diabetes and the medication I take to control my tendency to have seizures) increases the risk of heart defects, so I was advised to have the scan in order that any problems could be identified and either managed or prepared for. Although I’m glad that we got to have this scan, for the extra reassurance it offers, facing it is also another reminder of the risks that my body poses to my unborn child. My own heart breaks just a little bit to think that I may be unwittingly causing our baby harm at a time when they are supposed to be most safe and protected, cocooned in their little watery nest. Honestly, with all these cycles of fear, worry and guilt, it isn’t much wonder that I’m having a hard time enjoying this pregnancy.

All in all though, I was reasonably relaxed as we took the train up to London. Being a specialist scan, it was carried out in the cardiology department of a specialist children’s hospital rather than in our local hospital. It felt odd, attending a children’s hospital, but equally kind of appropriate as many would say I’m still a big kid, especially at heart! I already knew that the risk of problems was low, as nothing showed up on our routine anomaly scan last week. In the back of my head, though, was a nagging doubt because the sonographer at that scan had a hard time seeing a complete view of the heart.

As is becoming typical for our child, this scan wasn’t straightforward either. It was rather different to previous scans in that it focused straight in on the heart, which completely filled the viewing screen. However, Flangelina flatly refused to get in to the best position for the doctor performing the scan to see all that she needed to. We had a repeat performance of the hip wiggling and walking around that has been a feature of our three previous scans. The doctor kept pressing harder and harder in a vain attempt to achieve the required views or cause Flangelina to shift round. After about 15 minutes, my bladder was beginning to protest to the point that I desperately wanted to cross my legs and was involuntarily straining away from the scanning wand. At that point the doctor decided to ask me to wriggle around again.

“I can’t” I said, through half gritted teeth. “Unless you want a very wet examination couch. Do you think I could maybe empty my bladder? It might help?”
Fortunately I was granted a bathroom pass and I shuffled awkwardly across the corridor in my socked feet, not having bothered to refasten my trousers. Between my state of (un)dress and awkward gait, I must have looked like a confused granny, out of place in a children’s hospital.

Instant relief for me, but the lack of pressure from my bladder did nothing to improve the view of the heart though. After about another 10 minutes, during which the doctor remained silent and focused, she shook her head. “I need to get someone else to come and have a look at this.”

She must have seen the instantaneous look of fear flash across my face. Jumping straight to conclusions I assumed she needed a second opinion because she’d seen something tha concerned her.

“I just can’t still can’t see what I need to see” she said, sort of apologetically.

Eventually a senior member of the medical staff came in to the room. The original doctor shuffled through a quick introduction of my history and what she’d already seen. She seemed so uncomfortable and unsure as she spoke, half mumbling with eyes darting to the floor, that I instantly felt for her. It’s a position I’ve been in when I’ve needed to call for back up professionally. I’m always concerned that the patient may think I’m inexperienced or just plain incompetent and somehow I have trouble suppressing embarrassment that I need help. Ridiculous of course, and it was ridiculous in this situation too. We already knew that our kid is very stubborn and uncooperative. I was grateful, if anything, that she was being thorough and asking for another set of eyes.

The two doctors hunched over the ultrasound machine, chatting to one another about what was there. Periodically there were pauses as photographs were captured, and the grainy black and white images would flash with colour as the flow of blood was assesed. I was slightly in awe of this tiny heart beating away, knowing that it was deep inside me. The chatter seemed encouraging and eventually it came “That’s fine. I really can’t see anything. Everything looks exactly as it should.”

I had another appointment to attend in the adult hospital next door, to see my neurologst and review my medication. But as soon as that was over, we celebrated with more baby shopping, trekking home on the train with bags of bargins too good to resist – clothes, blankets and a microwave steriliser reduced to just a few pounds due to a damaged box.

I feel incredibly blessed. To have fallen pregnant in the first place. For the baby have grown to this point already. And for there to be no major problems detectable at this stage, despite the risks posed by my own ineffective body. Next stop is 24 weeks when Flangelina will be considered viable. This is going to happen and it’s going to be ok. I’m starting to feel much more sure of that.