The Appointment When Everything Changed

"Well, we've made it to another milestone - 34 weeks, which honestly felt impossible when I was admitted to the hospital at 30.5 weeks. We've also been riding the emotional waves of being a high-risk pregnancy for almost 7 weeks since all this started at 27.5 weeks. And yet, slowly but surely, we are making it - one appointment and one day at a time. 

Even for a standard, uncomplicated pregnancy, it is a season of life that can be uniquely stressful. After all, your body is changing every day, your hormones are raging, and there isn't a whole lot within your control. That feels like one of the hardest parts about this whole situation - it is out of my control and we don't really know why it's happening. I went into this pregnancy in what was probably the best shape of my life. I ran a near-PR in the marathon just before getting pregnant, and continued to run as things progressed. Up until things went haywire, I was regularly running 30-35 miles a week. I wasn't setting any speed records, but I loved getting out there to enjoy our beautiful mountain views 5 or 6 days a week. I eat a healthy, balanced diet, and I am lucky to not worry about high blood pressure. All that to say that I wasn't expecting to end up with a high-risk pregnancy and twice-weekly monitoring to make sure baby is happy and healthy." 

These are the words that have sat in my drafts folder for almost two weeks. I wrote these thoughts down before leaving to go to our regular round of checks at my 34+1 appointment. Little did I know that everything was about to change in a matter of hours. 

We got to our appointment and were happy to see Brooke, our favorite sonographer, greet us at the door to bring us back for our ultrasound. Each time, this was always the stressful part of our appointment since it's when we checked the umbilical dopplers. These had been elevated since 27+4 with one set of very intermittent absent end diastolic flow at 30+4. We generally knew that if we were going to run into a problem, it would be during this particular part of our visit. Brooke asked if a student could come in to watch and observe which we quickly agreed to, although I remember thinking to myself "I hope we don't make it too interesting for her." All looked great as the scan began - we got to see baby's sweet face and baby quickly checked off all the boxes to get an 8/8 on the BPP. I think Brooke got the first set of dopplers before Shane left to take Abby out to the car to go pee. They were elevated, unsurprisingly, after all, this was our normal. But, just moments after Shane and Abby went out to the car, we saw our first instance of absent flow. 

I immediately tensed up and I could tell Brooke got nervous too, but she kept her cool and continued to watch the waves and make sure it wasn't because baby was breathing. While I wish that had been the case, as she kept watching the dopplers, we saw several more instances of absent flow, even getting a stretch of 3 or 4 in a row. Brooke has done all but one of our ultrasounds, so we have really gotten to know her, and when she saw the string of absent flows, she muttered "damn it" before profusely apologizing. I quickly told her not to worry because that's exactly how I felt. 

For a little context, after my stay in the Maternal-Fetal medicine unit (aka pregnancy jail), my OB noted that if we had any absent flow before 34 weeks I would be readmitted to MFM. Except, if that happened, I would stay admitted until baby was born. But, if we had any absent flow after 34 weeks, it would mean delivery. So, as soon as I saw that absent flow, I knew things were all getting very, very real. Brooke left to go talk to the doctor on call as we waited on Shane and Abby to get back. I finally texted Shane that he needed to come back up ASAP, even though Abby hadn't used the potty yet. Once they got back, Brooke showed Shane the dopplers before graciously taking Abby to go play and explore in the hallway while the doctor came in to talk to us. 

As expected, my doctor explained that it was time to get this baby out. She asked practical questions about the last time I had anything to eat or drink and answered some of our questions (mostly Shane's I think because I was in shock and sitting there like a deer caught in headlights). I had a wide-eyed stare as I tried to hold back tears before my doctor finally said, "you don't need to hold it in. Just let it out - after all, this is exactly what you've been worried about for the last 7 weeks." Once the tears started, they didn't really stop for very long for the rest of the day. Through sobs, I began to voice some of my fears and concerns and questions. I think the first thing I choked out before sobbing was, "But Abby won't get to meet her." Before adding, "I might not even get to meet her." 

With a c-section looking like a strong possibility and a stay in the NICU inevitable, this was (and is) the hardest part for me. After months of excitement about a new baby on the way, I can barely imagine how hard it is for a 3-year old to wrap her mind around all that is happening. Besides pictures, she hasn't met the new baby, so it makes sense that it's hard for her to understand that baby Blueberry isn't in my belly anymore. Our doctor laid out a basic idea of what next steps would look like before going to call our hospital to let them know that we were on the way. She left to meet us at the hospital before we said our tear-filled goodbyes at my OB office. 

A bright spot in the day was opening the door to see all the staff laughing as Abby was hiking a balloon down the hallway. They were having a blast! Before we left, we decided to reveal baby's name. Shane explained that it was originally going to be a surprise, but given the circumstances we wanted to tell them first. Baby's name is Ellie Brooke, with the Brooke at least in part to honor the huge role Brooke played throughout this journey. At a group practice, I have seen a lot of different doctors over the weeks, but Brooke has been the constant. She was there for our first set of elevated dopplers, and with the exception of one scan, she has been with us every appointment up until the end. We hugged as everyone in the hall cried and then we took one last photo as a family of 3 before making our way to the hospital. <3 class="separator" div="" style="clear: both;">

We got there right around 3pm and I headed back to get checked in to my room. One challenge was that kids aren't allowed on the labor and delivery unit so Shane took her to the waiting room to keep her entertained while I got started. First step was to get on the monitors for my 17th and final non-stress test. Luckily, that looked great, so the big question became whether we would try an induction or opt for a c-section at 8:00pm (once it had been enough time since I last ate at 1:30). A huge part of me wanted to try laboring, with hopes of having a vaginal delivery. After all, with a c-section, I knew I wouldn't be able to pick Abby up for 6 weeks. Plus, the thought of a major surgery, no matter how standard it is, was absolutely terrifying to me. In favor of making this long story a little bit shorter, I ended up following the advice from my doctor and opting for the scheduled c-section later that night. Based on our long-standing concern about placental insufficiency, the likelihood of creating an emergency situation by laboring was just too high. Ultimately, I decided that I would rather live with the regret of wondering if I could have labored than live with the regret of knowing I created an emergency situation. 

Once that decision was made, it was mainly a waiting game. A close family friend from growing up in Asheville graciously came to hang out with Abby once she got off work at 5:00. The nurses also graciously let Abigail come back to my room to hang out with us for a little while. Most of this period is a blur of crying, signing consent forms, and getting prepared for surgery. I think it was around 7 when my dad got there to take Abby home. I sobbed some more and gave my big girl one last hug before she headed home. 

Right before 8, I walked towards the OR which was a wild experience. Shane hung back in the room to hang out and gown up until I was all prepped and ready. In the OR, I immediately started shaking - not because I was cold, but just from all the stress and adrenaline. I got my spinal tap, which took a little while to fully take effect. I could see everything happening in the reflection on the overhead spotlight, so I watched as they started the surgery. I became a little concerned that Shane hadn't come in yet, but he finally walked in and that made me feel better. I was also comforted by our birth playlist playing over the OR speakers, full of lots of worship songs, T-Swift, and other favorites. 

As "I am Set Free" by All Sons and Daughters played, sweet Ellie Brooke McIntosh was born at 8:35 pm, weighing 4 lb 4 oz and 18 in long. From the moment she was born she was feisty - she cried almost immediately and had her eyes wide open as the team brought her over to see me. Evidently she was also trying to grab stuff as the doctors evaluated her in the warmer. As anticipated, she is in the NICU now, but she made it into the world safely, and that was our ultimate hope and goal. November 7 will be a day we always remember - the appointment when everything changed and the day our newest baby girl was born