I had a “high risk pregnancy” for all 40 weeks + 5 days with my 4th child. The factors in my case were directly related to AMA (advanced maternal age). I was 42 when I became pregnant, via IVF/ICSI.(In-vitro Fertilization/Inter-cellular sperm injection) My body had been pregnant without ART 3 times in my 30’s—I had 3 healthy pregnancies and 3 healthy babies. I didn’t think about the chances of IVF/ICSI not working. My first transfer revealed a twin pregnancy, but I eventually miscarried both twins—the first at 6 weeks and the second a week later. As devastating as that was, my husband and I had a feeling that our baby was waiting to join us and we decided to try again. I became pregnant with twins a second time. This time, I cautiously heeded all of the warnings. I stayed in bed, received acupuncture for maintaining pregnancy and changed my diet to eliminate sugar, dairy and gluten. Still, around week 7, I had another miscarriage. This time, I was certain I had lost both twins. We were devastated.
At my appointment with the fertility specialists 3 days later, I fully expected the ultrasound to reveal a total loss. Miraculously, we were able to clearly see a heartbeat. One of the babies had held on! (This proves to be one of her personality traits to this day!)
I stayed cautiously optimistic, and continued my bedrest, diet and supportive treatments, but I continued to have vaginal bleeding until my 20th week of pregnancy.
Up to and for months afterward I underwent weekly ultrasounds to determine whether or not this “subchorionic hemorrhage “ had ceased.
Each visit held uncertainty as week to week, the bleed was still apparent. My subchorionic hemorrhage never resolved.
While the ART doctors were optimistic and encouraged me to transfer care to an OB practice in my area, I was still unsure of a viable pregnancy. Notwithstanding, I also hoped beyond hope for a healthy, full-term pregnancy and for a low intervention labor and birth.
Rob and I met and hired a doula. With her, we talked about our fears, hopes, and the possibility of having a VBAC. (My second child presented footling breech during delivery and necessitated an emergent C-section). My husband and I used hypno-babies, a childbirth education tool designed to teach self-hypnosis and experience a more comfortable birth.
I progressed into my 3rd trimester without bleeding, and cautiously began to return to a moderate activity level. I was seen 3x/week by my OB for a ‘non-stress test’ to see how baby was managing with uterine contractions—a common procedure with mamas of ‘advanced maternal age’.
At week 34, my ultrasound revealed a breech presentation.
With this new finding, I went crazy trying to flip my baby. I talked to her, went to acupuncture, burned moxa, saw a chiropractor, did inversions at home and in the pool, used peppermint EO on my belly and still, at week 38, this baby hadn’t flipped. We scheduled an external version (EV). While I trusted my care providers, I was a bit hesitant to try this, but my desire for a vaginal birth persisted and we went to the procedure. The EV was unsuccessful. We reluctantly scheduled a hospital visit the following week for pre-op registration. I resigned myself to a c-section.
At the hospital, in week 39, I asked for an ultrasound to confirm my baby’s position. I don’t have to tell you the joy I felt upon discovering her in a head down position. We would be able to try natural birth. My EDD came and went and our OB wanted to schedule surgery (I wasn’t eligible for induction because I’d had a previous c-section). Our team consisting of Rob, my doula and I discussed the pros and cons of waiting until week 41. At 40 + 5, Penelope made her entrance, born vaginally and my ‘high risk pregnancy’ had managed to produce a full (late) term, healthy baby, I remained healthy and we were all thrilled.
Throughout my pregnancy, from the time I interviewed and hired my doula, she was reassuring. She checked in regularly to get details from each prenatal OB visit. She discussed our biggest fears for pregnancy and labor as well as for our daughter. She provided me with evidenced based information regarding advanced maternal age, ‘due dates’, and positioning for birth. She instructed me in techniques and tools that I could use for flipping my breech baby. She was there from the beginning of active labor until Penelope was born, 13 hours later. She took photos of our birth and wrote a journal documenting each landmark in labor and delivery, including all of Penelope’s birth stats. She encouraged, supported and assisted with labor, and advocated for me with the hospital team around procedures that I questioned (constant fetal monitoring, Internal fetal monitoring, AROM). When my labor stalled, she knew and recommended the Miles Circuit, which helped develop a solid labor pattern. Our doula helped me into and out of the tub countless times, shared countless breathing and visualization techniques during labor and held my hands while I breathed my baby down. She ensured that my mom and Rob were eating and taking breaks, tag-teamed for counter pressure and hip squeezes, and ran errands for Rob while he supported me.
My high risk label didn’t change my doula’s care. If anything, she was more attentive, more diligent, and more supportive during my late pregnancy, labor and birth. She showed me that risk factors can be managed. She was an advocate for our family. I will never forget her, and will remain grateful for her woman’s wisdom, experience and care whenever I recall my pregnancy and Penelope’s birthday.
