Reaching fetal viability

From my last pregnancy I knew that 28 weeks was the first milestone, while 32 weeks was the absolute minimum. I stayed in bed and counted the days off. When I reached 28 weeks, I felt some confidence, but didn't let myself hope too much. At 30 weeks, my doc sent a fellow practitioner to check my progress externally. She was fine with me, but wanted me to take steroid shots to accelerate fetal lung development in case of pre-term labor. I had been feeling the baby move for a while and she told me to start keeping count. I started an excel sheet!

I asked my doc if I should get an ultrasound done, since I had no check up after week 18 and till the doc visited me at home at week 30, but she said she didn't want me moving before week 34, at which point, she would be fine even if she had to deliver then. Week 32 brought another home visit and all seemed fine. At week 34, we finally went for an ultrasound. At this point, it had been almost 4 months since we had any internal check done and we had NO idea what was going on inside, apart from the two home doc visits who just checked my belly externally for baby size and position.

At the ultrasound, it was amazing. We saw a 3-D ultrasound. We saw our baby....really developing. Everything looked great, till the sonologist hit us with a whammy....the umbilical cord was wrapped around the baby's neck...twice. It was a possible danger scenario, not so much of choking as the loops constricting nutrient supply to the baby and creating problems. Again, it was a case where the loops usually resolved themselves (though not two loops usually) and babies born with loops did survive. (My mom told us, she herself had been born with loops around her neck.) However, it was a complication, and my doc asked me to track fetal movements closely and keep check. Also, the baby was growing on track, except for her abdominal cavity which was 2 weeks behind. What more..seriously >.< We went home to wait it out. My doc had lifted my bed rest restriction, but I still followed it to some degree...what was a few weeks more anyway.

At 35-36 weeks, we had our next ultrasound. Amazingly, our baby had taken off both loops! Even our sonologist was amazed. At this point, finally I let myself start believing that this time..it might actually happen!! Unfortunately, the baby had turned and was now transverse, a position that again usually resolved itself, but in delivery, was impossible without caesarian. The doc told me to remember the head was near my right flank, not that I realized the significance of that comment at that time. We went home. It was Durga Puja. We spent it at home, only going for Navami morning puja, on the completion of my 37 weeks on Asthami Friday. The next day was Dussehra, at home, and then we had an appointment on Monday evening.

My doc was now keen to plan a C-section with the completion on 37 weeks (which completed on Friday)...the lower limit for a full term baby. I was still toying with the idea of a normal delivery though after my doc heard that the baby was transverse, that went out of the window. Transverse babies do resolve and my baby hadn't dropped yet, but with my history, my doc wasn't taking chances post 37 weeks. The baby had been 2.4kg in the 36 week ultrasound. 2.5kg is the lower limit for a normal weight range baby. We were sure baby would have crossed that.

I was tracking fetal movements on my excel sheet and it seemed to me there was a little drop in them, though still above the standard 10 kicks count. We fixed Thursday the 21st for the C-section. Booked the room, OT everything. On Monday 18th, when I went to meet my doc, I mentioned the change in fetal movement pattern. She was immediately disturbed. She sent me up for a monitoring test. The test showed within range, but when we spoke to her, she told me she wanted to deliver the next day, as soon as we got a slot in the OT. She told me the baby was probably over 2.5kg, we had made 37 weeks, at this point, it was absolutely fine to deliver. And while it was of benefit to keep the baby in as long as possible to pack on more weight, she would rather not take a risk with a precious pregnancy, with my history, and with my feeling of changed fetal movement pattern, however vague and unsubstantiated. In her terms, maternal instinct took precedence, even if I wasn't wholly sure. If I felt enough to raise the issue, it was enough. She wanted me to get admitted immediately for delivery next morning. I asked her if it was an emergency or could I go home and get admitted in the morning. She was ok with that next morning admission and we went back home.