Josh and I both had appointments today. First his...

We went to have the area from surgery checked out. He's fully healed, everything looks good and he can now resume all kid activities- yay!!! The area is starting to itch (which means the skin is healing) and there's still some firmness, and this is the deep tissues that are also still healing. The appointment was quick and anti-climatic.

Now mine...

I took Josh with me to my midwife appointment this morning. So far, everything checks out to be normal and healthy: weight increase is on target, diet is still good with room for improvement (as usual), uterus growth is on target, blood pressure healthy, baby's heartbeat strong and fast- like Josh's. We talked about some of the things I read about from Pithiviers and she's ok with everything except the "safety position" which isn't necessary. She informed me that the doctor who came up with that technique later recanted his stance stating that it really wasn't effective. So no change there- which is fine by me. She also suggested a warm bath for me and the newborn baby at the same time, or we could use a wash basin just for the baby. We talked about the sonogram from four weeks ago. Everything looked normal and healthy there except for one detail: the placenta is low lying. This didn't seem to be a cause of alarm to her though she'll monitor things to make sure things stay low risk. Apparently the placenta was measured to be 1.8 cm above the cervix. Two centimeters seems minuscule to me, but apparently this is enough to not cause alarm. We'll do another sonogram at 32 weeks to see how things have grown.

So I had to do some reading on what exactly a low lying placenta is and what it means. "Normally the placenta implants or buries itself into toward the middle or top of the womb. This means that it is well out of the way of the 'exit' when it comes to labour, and the baby has an easy passage out. When this doesn't happen, you are said to have a 'low lying placenta'. This can potentially cause complications when it comes time to give birth." [womens-health.co.uk] This is not uncommon- 15% to 20% of pregnancies have a low lying placenta. However, after 28 weeks, a low lying placenta is known as placenta previa. My midwife informs me that with a low lying placenta, it typically grows upward (toward the top of the womb, where the blood supply is best) as the uterus expands. This is good as at gives room for a normal labor. But, if it stays low at full term, there may be complications such an increased risk of early labor and bleeding.

This is not a common pregnancy complication as about 1 in every 250 pregnancies may have placenta previa. Placenta previa can cause severe bleeding during pregnancy. There are actually three types of previa:

1. Complete previa : occurs when the cervical os is completely covered
2. Partial previa : involves only a portion of the cervix being covered by the placenta
3. Marginal previa : extends just to the edge of the cervix

Diagnosing a previa is usually made when there is painless bleeding during the third trimester, although in many cases there are no signs at all. If it is diagnosed after the 20th week of your pregnancy (my sonogram was at week 20), and you are not experiencing any bleeding (I'm not), you may be simply asked to cut back on your activities, and increase the amount of time you spend in bed (darn!). You should, however, be alert for any bleeding in which case you will be put on bed rest, be told to refrain from sexual intercourse (bummer) and be monitored more closely by your practitioner (or midwife). [pregnancy-info.net]

SO! If I notice any bleeding, cramps, or unusual pain, I'll let everyone know, including my midwife. Until then, I'm to assume this will all be fine as nature works itself out. It's good to be informed and know what the risks and implications are in any unusual situation. Luckily, I'm not in an unusual situation yet.

Well, no more unusual than what my life is already. :-)

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