It is actually quite rare for anything to go seriously wrong during both pregnancy and birth, but when it does, it sure can make a woman feel like the mountain of joy is crumbling. My first pregnancy was absolutely perfect. I had not a single complication from beginning to end and labor and birth were no less amazing. This pregnancy has, until these past two weeks been no different. In fact, I have felt overall better energy-wise and the acne I suffered from in Theo's pregnancy (and that mostly continued until this new pregnancy) has totally vanished. My skin now looks better than it has in years! My weight gain has been normal and my uterine growth has been spot on. However at my last midwife appointment, we decided to do a third trimester hemoglobin (GB) test to make sure the the normal, healthy rate of blood expansion was happening (certainly expecting that it was).
Just for background, the maternal blood quantity grows by 50% by the third trimester. This allows for more fluids to be available for the baby both for food/drink, for their own growth, for amniotic fluid expansion, for adequate salt to be delivered to baby and so on. The process is vital. The HgB test is typically done in the first trimester to make sure that iron levels are good and to create a baseline measurement of hemoglobin,which is a predictor of blood fluid expansion as pregnancy goes on. As blood volume naturally grows, the components of the blood (such as iron and hemoglobin) become diluted. This is known as hemodilution and it is SUPPOSED to happen. This means that the HgB number that is found in the first trimester HgB test should be higher than the number found in the beginning of the third trimester.
Well, at my last appointment my hemoglobin measurement was 12.3 and at my first appointment it was 11.6. Going up is not good. This indicates that something is not happening correctly. It could be that my liver and/or kidneys are failing to do their job adequately, or that the placenta is weak. It could also be an indicator of the dangerous condition preeclampsia. Whoa. Hold on. There is no way that something could be going wrong in this pregnancy. I feel so great. The baby is moving all the time. Growth is good. What? When I heard this I literally felt my heart breaking and falling out of my chest, beating way too hard for it's own good. I soon became faint, sweaty and felt like I was going to not only throw up but definitely pass out. It was really, really weird. This had never happened to me all pregnancy so was it totally stress induced...or was it an immediate precursor to future problems?
Evidently, women do still feel pretty good going into their third trimester even when such conditions such as preeclampsia are beginning to manifest. However, very quickly she begins to get headaches, extreme fatigue, spilling protein in her urine (as indicated on at urine dip stick), may have trouble urinating, dizziness, blood pressure drastically rises, all of which leads to bed rest and often preterm labor. If left unwatched, (cause really there is no true treatment) can lead to eclampsia, which can manifest as maternal hemorrhage during labor/birth and possibly death.
So me being me, I did all the research that I could on hemodilution, high blood pressure (mine is historically really low, but has increased a bit as the pregnancy has gone on), preeclampsia, complications, remedies, precautions and preemptive ways to stop them from occuring. I poured through my midwifery books, raked through the Internet (though I do not really recommend this because there are more horror stories than anything else). The conclusion that I finally came to is that:
#1- I am not at all a likely candidate for preeclampsia/eclampsia. For the precursor's are a) overweight before pregnancy, b) high blood pressure, c) over 40 or under 20, d) had preeclampsia during proceeding pregnancy e) malnutrition f) severe dehydration. None of these apply to me in the least.
#2- the first HgB number was from a laboratory reading and the second frightful one was done in my midwives office with a hemoglometer. It is very, very possible that the two tests were fated to give different numbers. And I remember learning in my prenatal testing class that it is always best for two tests to be analyzed by the same mode in order for numbers to be reliable. This is true even between laboratories...always use the same method for assurance.
Upon this realization, I immediately contacted my midwives and requested for another lab test, not a hemoglometer test...and of course, being the wonderful women they are, obliged my request. So two weeks after the not-so-great results, I went back in to their office and they took my blood. That was yesterday, so I have at least until the middle of next week to wait to see how the numbers come back.
I tell you, it is painful. The very notion that my body could possibly be inadequately providing for my baby is horrendous. I have never known what is like to be one of those mothers that struggles to keep a healthy pregnancy...until now (maybe). Even if all is good and my hemoglobin numbers come back okay, I have learned some seriously valuable lessons regarding pregnancy and the imperfections that can occur, despite the mothers every effort to be as healthy as strong as possible.
This again is about surrendering to that which we cannot control. It is a good lesson for mothers to learn, for as pregnancy, labor, birth and then childhood unravel, there is so much that is not within the realm of maternal control.
I am certain these understandings will help me to be a better midwife someday......
I will post the results as soon as they come.
