This morning I had my third fetal assessment. Baby is doing great and everyone was happy…yet I still left the hospital feeling a bit dejected. Here’s why…
At my first fetal assessment – 3 weeks ago – Baby was at the 45th percentile for size. Perfectly normally average. Loved it.
At my second fetal assessment – 1 week ago – the “percentile chart” was shown to me with no specific numbers given.
“Here.” The nurse said, and stabbed her pen at two little x’s on the graph. ”Here’s where she was last time” (pointing at the x just below the mid-line) “and here’s where she is this time” (pointing at the x slightly higher above the mid-line). ”Everything looks great!” And we left.
At today’s fetal assessment, the nurse said, “She looks great! 75th percentile, just like last time.”
Wait, what? I had been led to understand that she was only a tad above that mid-line (i.e. 50th percentile) last time…1 week ago.
In my last pregnancy, right around 33-34 weeks (for comparison, we’re 33 weeks now) The Kid jumped from 60th percentile to a point above 90th, in spite of tight control of my diabetes, and at that point we started talking about risks and early c-sections and all that fun stuff. I’ve been really really hoping to avoid going down that path this time. My control is even tighter with this pregnancy (A1C hovering right around 6.0% this time as compared to 6.5% last time), and I’m rarely having highs to speak of. I see a few numbers around 8-9 mmol/l (145-160 mg/dl) every day, but rarely higher, and I correct them uber-fast! So I’ve been convincing myself that Baby B is not going to have the same growth spike that The Kid did.
The nurse didn’t seem nearly as worried as me. She pulled out the chart again and showed me the little floating x’s. She showed me the “slight” jump that occurred in the two weeks between F.A. #1 and F.A. #2, and she showed me that the growth was nice and consistent now. She also showed me that all three x’s were well inside of the “safe” zone - the upper and lower lines that set off alarm bells when you creep over them (or so I assume). She also reminded me of the 15% error rate, meaning my 45th percentile could have been 60th, and these 75th percentiles…well, they also could have been 60th.
In other words, she wasn’t worried. Nor should I be. And I suppose I’m not…not totally, anyway.
But then she said to me – very pleasantly and totally non-accusatory…
“Growth at the end is common with Type 1 diabetes. It’s why we watch you so closely.”
Clearly she doesn’t know me.
Clearly she doesn’t know my spreadsheets, my carb control, my self-control, my obsessive blood-testing or my wakeful nights of correcting levels that are only slightly too high. Clearly she doesn’t know that every ounce of my energy is being poured into be uncommon when it comes to Type 1 diabetes in pregnancy.
Clearly she doesn’t know that this explanation is not one that will make me feel better.
I’m hoping we hold fast to this 75th percentile. I only have 4-5 weeks left now, and I’m awfully tired – physically and mentally. I’m doing all that I can – literally everything that I can muster – to trick this Baby into thinking she’s living in a non-diabetic environment. So far I’ve seen great results of all this work – happy healthcare professionals, gorgeous A1C, and (so far) none of the same nasty complications that I had last time around.
But the ultimate result that I’m looking for – the main goal of all of this hard work – is for Baby to be unaffected by my diabetes. Normal size, normal development, normal timing of delivery (or as close to it as possible – I’ll settle for 37-38 weeks).
And so that she can experience normal, I’m determined not to settle for common.