Changes are on the way!

The last few days have been a roller coaster ride for all of us. My blog has now turned into a diary as I begin to keep track of all the changes. I know many of our friends and family are concerned and want details, so I thought this will be a good way to keep everyone informed. I also want to have this for Gracelyn and me to read one day. Every baby has their own way of entering this world and I want to paint a picture of her special day! We have our list of family and friends to start the phone chain if anything alarming should happen. We ask everyone for prayers for baby Gracelyn. Thanks to each and every one of you for all your support. We love you all!

Thursday, July 12^th- very busy day at work, felt a lot of lower abdominal pressure, went to dinner with friends, and then to Kohl’s… as I was walking into Kohl’s I felt a sudden muscle pull in my belly. I didn’t think anything about it and kept shopping.  When I got home and changed into my PJ’s I noticed my belly looked a little different. When I look down now I can’t see my belly button.  My belly appears to have dropped. Gracelyn’s little butt which rides high near my upper ribs is now located mid belly. Jake looked at my belly and thinks the same… It appears Gracelyn may have dropped into the “birthing canal”.  This is a bit alarming for a first time mom. We are just turned 33 weeks.

Friday, July 13^th- I wake up and my belly still looks low. I get to work and ask some of my co-workers and they all agree Gracelyn has dropped. I get a little nervous because we have plans to leave for the beach (Nags Head) on Saturday. I called the OB just to see what they have to say. I was worried … is this too early for her to “drop”? The OB works me in for a 10:30am apt. I see Dr. Privette and she does a Fetal Fibronectin Test and a Cervical check.  I am a fingertip dilated and we will have to wait until the afternoon for my results from the FFT.  About 2:30pm I get a phone call from the OB nurse and she informs me that my test came back positive.  We were hoping for negative results.  Negative results are 99% that I will not go into labor within the next 14 days. A positive test however can be a little more indecisive.  The nurse tells me to pay attention to my body and be on the lookout for any signs of labor. The Dr. schedules a follow up appointment on Monday at 9:30am to recheck for dilation. I was given instructions to take it easy and drink plenty of fluids.

Fetal fibronectin is a protein that acts as a "glue" during pregnancy, attaching the amniotic sac — the fluid-filled membrane that cushions your baby in the uterus — to the lining of the uterus.

Fetal fibronectin is often present in cervical secretions during early pregnancy. Fetal fibronectin also shows up later in pregnancy, about one to three weeks before labor begins. If your health care provider is concerned about preterm labor, he or she may test a swab from your cervical canal for the presence of fetal fibronectin. A positive fetal fibronectin test is a clue that the "glue" has been disturbed and you're at increased risk of preterm labor.

When the fFN test is positive, it is an inconclusive result. A positive result can indicate that a woman will go into preterm labor soon, but she may not go into labor for weeks. When the fFN test is negative, the result is a better predictor. A negative result means that there is little possibility of preterm labour within the next 7 to 10 days, and the test can be repeated weekly for women who remain at high risk. A negative fetal fibronectin test gives a more than 95% likelihood of remaining undelivered for the next 2 weeks.^[2] A systematic review of the medical literature found that fetal fibronectin is a good predictor of spontaneous preterm birth before cervical dilation.^[3] The test may be run on patients between 22 and 35 weeks gestation.

Saturday/Sunday- It’s been a very l-o-n-g weekend. Everyone has left for the beach and we are waiting for Monday. I’m a bit stressed about what a positive FFT means Mom (grandma Baker) comes over and stays the night, helping clean, fold baby clothes, and helps to keep me comfortable.

Monday, July 16^th- Appointment with Dr. Harden.  Dr. Harden walks in and says, “We are still pregnant!” in a happy, but humorous, tone. He has been delivering babies for over 30 years. He is very experienced and I trust his judgment 100%. I am rechecked and remain a fingertip dilated and he notes that my cervix has started to thin (effacement). He does not give a percentage just makes the statement that it’s started to thin.

What is effacement?

Effacement is the process by which the cervix prepares for delivery. After the baby has engaged in the pelvis, it gradually drops closer to the cervix; the cervix gradually softens, shortens and becomes thinner. You might hear phrases like "ripens," or "cervical thinning" which refer to effacement.

How is effacement measured?

Effacement is measured in percentages. For example, your health care provider may tell you that you are effaced 50%, which means you are half way to being completely effaced. When you are 100% effaced or completely effaced, your cervix is paper-thin and labor is right around the corner.

Dr. Harden also advises it is not a good idea to go to Nags Head and remain at home on the couch. He puts me on modified bed rest and schedules a follow up appointment for Monday July 23^rd. I did have a few questions for him:

Could the positive FFT indicate anything other than preterm labor?  No, it is just a sign that my body is preparing for delivery.

Is Betamethasone needed at this time? No, you are so close to 34 weeks you will be fine without it. After 34 weeks nothing is given for lung development or to stall labor. At 34 weeks we let your body do what it has been preparing for these last few months.

Betamethasone and dexamethasone cause an immature fetus's lungs to produce a compound called surfactant. A full-term baby's lungs naturally produce surfactant, which lubricates the lining of the air sacs within the lungs. This allows the inner surfaces of the air sacs to slide against one another without sticking during breathing. Premature infants whose lungs have begun producing surfactant are more able to breathe on their own, or with less respiratory treatment, after birth.

 Dr. Harden helps to reassure me that I can remain at this stage for weeks, but he does not hold a crystal ball and I could deliver as soon as tomorrow. Some good news is that Gracelyn is kicking and moving all over the place, her heart rate steady in the 140’s, and she measures at 33 weeks. This is good evidence she is doing just fine in my belly, but maybe she is just a little stubborn like her mommy and wants to come out and play. 

Tuesday Night July, 17th: Around 6:30 I experience a lot of tightening in my belly and it is somewhat alarming. I’m not doing anything at this point but sitting on the couch watching TV. It goes away within a few seconds and I think probably just a Braxton hick contraction. About an hour later I get up to go to the bathroom and my belly suddenly gets tight and hard… this is definitely different than an hour ago. My entire belly is rock hard and you can see through my dress my belly tighten and contract. I immediately go lie down on my left side and start to drink lots of water. What feels to me like a contraction last for about 60 seconds and then my belly returns to a soft round baby belly.  The tightening, all over hard belly returns 2 more times when I stand to go to the bathroom. I get right back in bed and both times the sensation lasts for about a minute. The final straw:  I am lying in bed and the tightening begins with no movement this time. I get my phone out and again it last for about 60 seconds. I call Jackie (Jeff’s mom- who is an OB nurse) She advises me to continue what I’m doing and with my current situation it wouldn’t be a bad idea to call the Dr. and let them know what’s going on. I call the OB and Dr. Wheeler advises me to come in to get checked out. We arrive at Wake Med around 10:00pm- it was such a smooth process. They are ready for me as soon as I walk in the ER and up to triage I go. The nurse is standing at the door as I exit the elevator and she starts the work up within seconds. Gracelyn is all hooked up with no signs of contractions, her heart rate stable, and all looks good. Dr. Wheeler is in a delivery and comes to see me within the hour. I’m rechecked and remain a fingertip dilated, but now am  75% effaced. Dr. Wheeler then decides since I’m not quite 34 weeks the Betamethasone is a good idea. My first injection is given in the hospital and after a few more hours of monitoring we are on our way home. Dr. Wheeler lets us know at this point if things continue to progress after 34 weeks they will not do anything to stall labor. At this stage in the game the outlook is safe for a delivery with some assistance from NICU. A follow up appointment is scheduled with the OB office for Thursday morning at 11:00am where I will be rechecked and my last dose of Betamethasone will be given.

I want to think all of our family and friends for being so supportive during this time. Everyone has been so thoughtful and so many prayers have been sent for baby Gracelyn. We are truly blessed to have such an awesome support system. We could not do this without each one of you. It has definitely been a roller coaster ride these last few days and I don’t plan for anything to slow down at this point. The only thing we can do at this time is put this in the Lord’s hands and continue to pray.  The positives from our adventure last night; We had a trial run to the hospital, know the shortcut to the hospital and do not have to rely on the GPS, have another day to pack a hospital bag and get a check list together, and most important a round of steroids on board and no baby yet.