GBS

38 weeks, 4 days
(prepare for longest blog post, ever)

Perhaps my last post about GBS was a little vague - here let's get statistical!   I will say it was a good test of blogging from my phone, should I need to send out any brief birth announcements in the upcoming days!  :)

What is GBS?  It stands for Group B Strep.  It is a normal bacteria in our bodies, but sometimes causes death in newborns.  Pretty serious stuff.  Let's look at what "sometimes" means:

So if you have GBS (which I did, at least two weeks ago - well, they say the test is 87% accurate), 50% of babies will be colonized by it, and 1-2% will get sick.  So that's 0.5-1% of babies will become sick (serious consequences including death/life long disability).  To quote the midwives, of 17 500-50 000 pregnant women, 1-4.5 babies will die due to GBS.

Who are these babies?  There are some risk factors that make it much more likely it will be babies of a certain set rather than others:

• Preterm [thankfully, Appleseed is not!]
• Baby weighs less than 5 lb 8 oz [the last u/s put Appleseed at 6 lb 8 oz, which makes me SUPER happy, but I know that is not the most accurate of measurements, so am not banking on it]
• Previous baby with GBS disease  [thankfully, no]
• Water broken for more than 18 hrs
• Fever during labour

So what is to be done?  Two common choices:

1. Take IV antibiotics during labour if you test +ve for GBS
2. Take IV antibiotics during labour if you test +ve for GBS and have another risk factor.

Life is further complicated by the fact that I'm probably allergic to penicillin, and so have to take clindamycin.    This means two courses of IV antibiotics during labour (6-8 hours apart) vs only one course with penicillin.  And these aren't getting little nudges of antibiotics, they really whack you with them.  And if my labour is less than 6-8 hours long?   It will be like I didn't do it (in the view of medical professionals, anyway).

Ok, CS, just take the antibiotics, what's the big deal?

Again, looking at the stats is very interesting.  With choice #1, 30% of preggos receive IV antibiotic.  This leads to GBS (/other) antibiotic resistance.  The lamest stat of all is that 21% of GBS strains were resistant to clindamycin, while none were resistant to penicillin (yet?).  But nothing to be done about that.  Sorry Appleseed!  Blame Grandma for calling "allergic" without proper testing!  Can't test now - pregnant!

With choice #2, 3.4% of preggos receive IV antibiotics.  Quite a dramatic decline.  One would argue that's almost everyone that needs it.

We can say it like this.  With #1, about a 1000 infants receive antibiotics during birth to prevent one GBS death.  With #2, about 6 infants receive antibiotics during birth to prevent one GBS death.  That's pretty striking.

Why say almost?  Success rates of methods 1 and 2:

1. 65-86%
2. 51-75%

So even if I do opt for antibiotics with no other risk factor, it isn't 100% successful in preventing GBS disease.  That's sort of surprising, right?  Here is what they don't tell you - those 14-35% of babies that STILL get GBS - do they belong to a particular group of babies?  Like, are they all preterm?  They don't say.  Interestingly, the majority of those 14-35% are of mothers that screen GBS negative - that should give you the willies!  (sorry)

Still seems like slightly improved chances if I just take the antibiotics no matter what.  BUT - what about the downside of antibiotics?

• Yeast infections - not life threatening, but a bummer, and can cause breast feeding drama
• Potential for baby to be allergic to the antibiotics (rare, not too worried about this - 1 in 10 000)
• Death from Antibiotics (very rare, 1 in 100 000)
• Public Health concerns about growing strain resistance
• Potential for increased allergies or asthma for Appleseed.  

There is where I struggle -  potential for increased allergies or asthma for Appleseed.  By maybe overreacting, I am maybe increasing her risk of allergies and/or asthma.  We have TONS of allergies in the family.  I really struggle with starting her off on that path.  The data totally isn't clear on this point. 

And that's where I stand today.  I'm leaning towards only taking the antibiotics if I have a second risk factor.  Even though the official risk bar is set at 18 hrs for membranes ruptured before baby comes, some studies indicate risk begins to slowly climb after 6 hrs.  I will ask about that - can I change my mind after 6/8/12 hours of ruptured membranes?

I'm planning on talking to a friend of mine who I think was GBS positive, and also to my doctor friend, for their opinions.  And this does not preclude a home birth - midwife can give IV antibiotics while I'm at home, no worries.  So at least that is uncomplicated!

If interested, the real (LONG TECHNICAL) details are here.

A very interesting quote about garlic (and for the LIFE OF ME I tried to find this full document online - our public library should give us access, but no dice).  There is no research to back it up....but maybe it can't hurt....?

State of the Union

38 weeks, 3 days

Well, I am officially off on mat leave now!  Whee!  That is not strictly true - I found out I had 5 vacation days I had to use or lose, and so on Wednesday last week I decided to go on vacation this upcoming week!  So I'll be on vacation as of Monday.  :)  Sort of a lame way to spend vacation (laying on couch?), but better than losing it!

It was a bit of a shock to the system - all of a sudden it was like "tomorrow is going to be my last day!".  Which seems weird, all I do is complain about work - but it isn't so bad, and I have my work friends, who I will kinda miss.... But of course I won't really miss it.  I want to snuggle my baby for the next year!  Woohoo!

That seems crazy too.  It still seems far away.

 So I've been having more and more Braxton-Hicks/prodermal labour.  Pretty much if I stand too long or walk, there will be a contraction.  Not apparently as bad as ones that will be coming, but still they are now quite powerful-ish, I wouldn't call them comfortable.

Good Friday was kind of a hard day for me (remember Good Friday is a stat holiday in Canada).  Our church was stations 4-6, so the choir had to show up early to practise.  And the choir in this case was standing for the entire thing.  About halfway through my choir friend looked over at me and said, "Standing is ok for you?" and I was like "No", and she was like "SIT DOWN!" - so I took her advice and did sit down when we weren't singing (there were long solo parts).

Then, I really wanted to keep following the rest of the stations.  We are not usually in the City for Easter weekend, I might not have another chance for years!  So off DH and I went - but even though this is just a regular amount of walking to the next church, and of course once you get there you sit down, it was quite uncomfortable. 

Then we realised our dentist appointments were rather soon, so we had to bail on the last few stations (after seeing the inside of our local HUGE catholic church - very pretty!  but MONSTER SIZED!  and I thought our church was big - nope!  ha!).  So we left - and we took the SUBWAY home.  We had never done this.  It is only a few stops, and completely walkable.  But I was just too uncomfortable.

Hahha - lame, right?  Even at the dentist (turns out we were early, so we had time to grab lunch), DH was like "where do you want to go?" and I was like "the closest place possible".  I even took the elevator there.  Yikes.  It is only on the 3rd floor!  It is one of those creepy small smelly elevators, I had never even considered it before.

At the dentist, the receptionist was like "Another few months left?", and I was like "Haha - no.  Another week or so", and she got all shocked and told us to go eat lunch because I need to eat more.   Yes, I didn't end up getting all that huge!  Compared to most ladies, I don't look full term at all.  I was hoping for a big ginourmous bump, but that wasn't in the cards.  (And I certainly haven't been curtailing any eating!  Bring on the full fat dairy, I say!)

I did nap in the afternoon, and things calmed down.  It totally isn't real labour or anything, otherwise napping wouldn't chill things out.  I asked my midwife if these could be getting me ready, and while she was positive about me having them, she did say they wouldn't open the cervix.  So now they are seeming like a waste of energy to me.  I've been having BH for ages now - I was thinking of them as going to the "uterus gym".  So my uterus should be quite strong.  It is enough now, yes?

I had to do some relaxation stuff last night to calm down - getting all ansy wasn't helping anything.  I just have to chillax and wait to see how things go.  But I am SUPER glad I won't be at work next week.

I can't believe we're having a baby soon.  It still blows my mind, seems unreal.  Too many years of buildup, maybe.  But we're very very excited.  I'm sort of worried I won't be able to stay in my Hyponobirthing relaxation during labour just because I'm so darn EXCITED!  I picture more of that weeping-because-I'm-happy stuff.  :)

If you have any intentions you'd like me to pray for you while I'm in labour, please comment below!  I'll do my best!  I do plan on of course thinking about my IF sisters still waiting,  You ladies are never far from my thoughts - I know you'd switch places with me in an instant, I don't feel worthy of such good fortune.

GBS positive

Boooooooooooooo
I am kinda bummed.  Lots of reading ahead of me.

Portents

37 weeks, 4 days

Well, things are ramping up here in the Appleseed household.  Thursday I was feeling super great, and I was like "Forget 39 weeks, I should work until 40 weeks!".  But then Thursday night I was all...not feeling great.

My Braxton Hicks have amped up a bit, I was a bit thrown.  They're not regular or anything, and I'm mostly ignoring them (well, besides doing the breathing).  I skipped choir and needed two bowls of cherry ice cream.  This is the second pg thing I've sent DH out for - the first being perogies AGES ago.  Sure, yes, I am not a fan of commercial ice cream - but somehow those cherries were delicious and soothing.

Friday I also wasn't feeling super at work, at least in the morning - but then I was ok in the afternoon.  People kept stopping me in the morning and telling me I should rest more.  Oh dear.

So I sort of freaked out a little - like, maybe Appleseed will come earlier rather than later?  And we're NOT ready.  So Saturday we made a big list (which is prioritised) about things that we'd like to do before her big arrival on the outside scene.

We decided on no bassinet (they seemed like a huge rip off, or physically huge, which we don't have space for in our room), so we're going to use a piece of foam next to the bed.  DH made some sheets for it today, we bought some cute-ish fabric yesterday (polka dots).  The foam is pretty much the size of the space between the bed and the wall, so she'll be all snug and cozy down there.  And it is much thicker than a bassinet mattress, so that's a positive (yet still nice and firm).

We have no diapers yet (well, ok, we have 2, but that isn't going to cut it)!  Hahha - our diapers are coming with my friend's visit on Easter weekend.  Obvi we'll dash out and buy disposables if she comes early, it just seems funny to me.  Shows how much we really think/thought she was going to come late or at least not early.

She may still come late - I've never done this before, I don't really know.  Maybe the next four weeks will be like this?  Very strong BH - they don't hurt, but they are more powerful than before.  And [TMI] I checked my cervix - it seems soft but closed.  So that's fine - slowly getting into shape, maybe?

Did y'all have BH?  I am always surprised when people say they didn't have them at all - I've been having them for ages now.

Today at Church was sort of hard.  I freaked out and made sure the hospital bag and homebirth kit were ready, then I needed a nap.  I was supposed to go out to walk to the library this aft, but I bailed.  Seemed too hard to do - hahha - lame!  But I do think I maybe needed that nap.  Sometimes Church can be emotional, you know?  Or it is just me.  I did watch the Katy Perry movie this afternoon, and it made me cry.  For like 5 minutes.

Then I had a bath and 'did a Rainbow'.  While it sounds like that is some sort of street drug, it is just my hypnobirthing rainbow relaxation I listen to.  Worked quite well.  I also recorded myself last night doing a deepening script, and I listened to it last night.  Seemed to work quite well last night, even though I think I rushed it a bit, and would re-record if I had time.  But I decided I'd probably drown if I got that relaxed in the bath today, since the Rainbow worked so well!  ;)

I'll keep you posted!

Midwife home visit

36 weeks, 6 days

Today was the visit I'd been waiting for a long time.  The midwife home visit.  The marvellous midwife came over, we had tea (FUN, right?), and we discussed birthing.  She also did the regular checks and everything is fine.  My GBS result is not back yet.

I was a bit worried our staircase was too narrow for a home birth.  This would have been a drag, totally changing our plans around.  But nope - it is fine!  She even said the midwifery clinic (where you can birth if you choose to) has slightly more narrow stairs, so that's fine.

She loved our tub, said it would be great for labouring!  Hooray!  She said in general our house was perfect for a home birth!  Double Hooray!  It's ON.  (Also good we have a second bathroom in the basement, in case someone has to use the facilities and I'm all cozy upstairs in the bathtub - hah!  I had never thought of that!)

Also she mentioned I should not go up or down stairs for at least 3 days after birth - how do people manage that when they birth in the hospital, I wonder?  I'm cool with this - all part of our "one month" plan.  7 days in the bed to start with.  I'm glad she stated that '3 days no stairs' rule so clearly though, it will help DH and I.

Even though she's 99.99% sure that her head is down and (partially?) engaged, because we're having a home birth she wants to check again.  Apparently since Appleseed's head is so far down, it is hard to be 100% sure it is a head.  I'm SO ok with this.  Another chance to say hello to the Appleseed?  Fo' shizzle!

We went over my birth preferences, which all all standard midwife-y kind of stuff, so no surprises.  I did make sure to mention I want Appleseed to be on my chest when she's getting her Vitamin K shot and eye antibiotics, and she said absolutely, that was their standard practise.  Excellent.  Apparently it is much more soothing for the baby that way.  And if in a hospital, that is NOT standard.  So be sure to ask, ladies.  :)

Also, the big burning question - glasses or contacts?  I am SUPER blind, so need some vision enhancer if I don't want to be led around everywhere.  And to see my freshly born baby when she arrives.  :)  She said contacts would be fine, just to remember if I end up in the hospital for a C-section I would have to switch to glasses then, so to have contact stuff in my hospital bag.  Ok!

Today was also my first chiropractic appointment with a chiro in the area who is experienced (/loves) working with preggos.  I'm going to try to see her about twice a week until the birth, to 1. fix my back, and 2. allow Appleseed to be in the best position possible.  My back did hurt after the adjustments, she recommended I have an Epsom salt bath, so I did.  My first one in the new bath tub!

Super fabulous. I kept it not-hot (no cooking of Appleseeds), which wasn't as bad as I thought it would be.  Also I didn't super-fill it, so my abdomen was not actually in the water - so it was cool the whole time.  But still I was soooooo relaxed by the bath!  Awesome!  I'm glad I had my first bath in the new tub before labour is actually here, now I know more what to expect.  Then the bath made me sleepy and I had a wee nap.

What a great day.  I was (/am) just so happy all day.  I can't believe this is all happening to ME.  Wonderful!

[I recommend to all hot water bottles I meet that they immediately don a sweater.]

36 weeks, 1 day

Today we met with the backup (2nd) midwife again.  We still know her least of the three, so it was good to get a little more face time with her.

I did my Group B step swab today.  Yikes!  REALLY HOPE I don't have it!  With me being "allergic" to penicillin, it will be all sorts of drama.  Better to not have to travel that road.  I'll find out sometime next week.  Hope all those probiotics did their thing!

Today was also the day we get the 'home kit'.  I sort of thought this was going to be some reading material.  There is that too, but it is literally like hospital pads and things.  In a small garbage bag!

Wowzers.  She said to keep it together so when they come over it will be ready for them.  This sh*t be getting real!  :)  (hooray!)  (sorry for the fake swearing!)

And also I have a copy of my records now.  From now on I'm to leave them in my purse.  In case of emergency, say I have to go to a hospital I'm not registered at, I'll have all my relevant info with me.  Yes, I actually am registered already at the hospital my midwife works out of - just in case, you never know.

The plan is still to birth at home, but you never know, things can go awry.  Hospital is 10 mins away, so don't worry.  :)

For my next midwife visit, my primary midwife comes to our house!!  Cool!  I have been looking forward to that!  She will give a yay/nay on the homebirthing thing.  Are our stairs too narrow?  Maybe.  We shall see!  If she feels it is not suitable, we can birth at the clinic (meh) or the hospital (might as well?).

Also, my midwife is also an alto in our church choir you may remember - so it will be like having a buddy over - fun!  We can have tea.  :)  (She is a total tea addict - she requested black tea with 2% milk for the birthing.  I like it.)

Also, from now on I'm having midwife appointments once per week!  HOORAY!  This is somehow a huge milestone for me.  Can you believe Appleseed and I have made it this far?  I am so happy.  AND I love working from home, it really breaks up the week.  Now, totally justified.

By the numbers
Blood pressure: 100/60 - well, no pre-eclampsia here yet (knock wood), that is still rather low
Size of tummy:  35cm.  Excellent.  I am 36 weeks, so that is "1 cm" below average, within a 2-3cm tolerance.  I am very pleased.
Heartbeat: 140  :)  All good!

I had some crazy backache last yesterday, which was pretty bad in the evening (hurt to walk, get up - poor DH had to help me a lot).  Thank goodness I had my hot water bottle that wears a sweater.  It really helped!  My back has been pretty ok so far, so I'm not complaining or anything.  Maybe she has dropped a bit, and that is causing the back pain?  It's very manageable with the hot water bottle that wears a sweater (thank you Feather!  Love it still!). 

The midwife did say her head was low - I have the impression it's not super low, but low enough it won't be able to turn up.  Fine by me.  :)

And last but not least (sorry for such long posts lately!) - congrats to all my Catholic ladies on your new Pope!  An exciting choice.  :)  (I had been sort of rooting for the Canadian fellow, but it was not to be.)

Surprise Work Baby Shower!

36 weeks, 1 day

Well, yesterday totally out of the blue (from my perspective) was my work baby shower!

Hahah - and I'd been lately wondering <in a sad voice in my head> "I wonder if they will send a card around?".

Turns out it was this whole orchestrated thing!

My boss two weeks ago made SURE I was going to be at work for my "review".  This seemed a little odd to me - generally if she or I can't make these 1:1 meetings, we just move it to the next day, no harm done.  But I thought, ok, the review does have to get done by a certain date.

And then yesterday, she messaged me something came up and she'd be a few minutes late to start, that she'd swing by my desk because she had to get her laptop charger anyway (we sit next to each other).  All very plausible.

Then she came by, and we chatted TOTALLY normally (imho) on the way to the conference room.  We were stopped along the way by a colleague (who was in on it), who was like, "I need CS right now for an urgent problem".  I think this was a bit odd as generally those dudes don't have urgent problems I can help with (he's in marketing), but we ended up agreeing he could wait until after my review.

My boss this whole time was going on about how it was so important to have my review done this week, as my pg is advancing and we don't know how things are going to go, when exactly I'll be off work if the baby comes early.  I, of course, totally bought it.

THEN, we went to a small conference room (the size you would book for a meeting with 2 people), and it had people in it.  This is a rather common occurrence, somehow the system takes double bookings from time to time.  So we backed out, and said we'd try to find another room.  Turns out she had told them she would be coming in and then be leaving!

So the farce continues, she said "let's try one of the big rooms, they are sometimes free", and she turned and tried the closest big room, and I'm thinking "it seems like there are people in there", but I didn't even have a moment to stop her, and I was thinking "well, if she opens the door and sees people we'll try somewhere else" - and WHAMMO!

"SURPRISE!"

How nice of them!  And complicated!

There were two cakes, and a basket of fun baby stuff, and two cards, and VIS.A giftcards.  Wowee.  Super nice and VERY generous of them!

And we still need to buy that bassinet and a crib mattress, this should cover it handily.  And I will probably return most of what they got me in the basket (because I already have 1001 bibs handed down to me, and the creams aren't hippie enough for me), so that's more money I could spend on potentially a breast pump (also do not have yet).  But some things are great - crib sheets!  Yay!  We had only one, two is best!

Haha - you should have seen me.  I was overwhelmed a bit.