Baby not measuring to dates

So I’m about as easy and vanilla a maternity patient as you can find. My blood pressure today was 116 over 81. My weight gain is normal (if perhaps a little donut-enhanced). All my tests (for strep, yeast infections, etc.) came back negative. I do not have gestational diabetes. My birth history is uncomplicated. My overall health is excellent. The baby’s heartbeat has been at 140 – 144 bpm every single appointment since the first heartbeat was spotted at 10 weeks. He’s very active. I don’t smoke, have pre-existing health problems, genetic predispositions to health problems, or any other complication. I’m well within the age range for not worrying. If there was a woman out there who could probably skip most prenatal care without harm, it’s me. I’d be fine so far this pregnancy, without a single medical intervention.

Do you hear a rant coming on?

There are a few things you do in the last month nearly every exam:
1) Pee in a cup (to check for protein — a sign of preeclampsia)
2) Take your blood pressure (also a preeclampsia check)
3) Check your weight (mmmmm donuts….)
4) Check the baby’s heartbeat
5) Measure the size of the baby.
6) Answer any questions you might have.

Step #5 is done with a little tape measurer. You lie down and the practitioner takes the tape and measures from the crease that starts in my case right below my boobs, over my belly button and to my pelvic bone. (Hurts when she presses down on it.) After like 14 weeks or something there’s a 1 to 1 correlation between number of weeks and the centimeters on the tape, so at 28 weeks the bump should be 28 cm. Convenient like that.

For the last 37 weeks of my pregnancy there has been NO MENTION made of the size of the baby. (Although he was the correct size in the very early ultrasounds where size matches dating.) This is my third midwife appointment in the last 4 weeks. The previous two she was gossiping while measuring and nothing came up.

Today she gets this concerned look on her face and asks if I would have an objection to going in for an ultrasound because the baby is measuring small. I pointed out that I fell under the birth weight threshold (at three weeks post due!)

So the upshot is that I have an ultrasound tomorrow to check the sizing on this baby. The thing is… um, so what? (The questions I should’ve asked all come to me as I stand in line for a donut at Starbucks.) What could be wrong with a small baby that we would currently have a chance to do something about? What are you worried about regarding the smallness? Has he been measuring consistently fine and then just failed to grow at all this week? Is that really a cause for concern? Or has he been running further and further behind and I just wasn’t told until she got really worried? Do we think he’s sitting on his umbilical cord? (Heartbeat was just fine…) It sure isn’t that I’m not eating enough. I could understand if he was measuring large — we might want to see if he would still fit and maybe induce labor a bit early to avoid a c-section if there was a doubt about him being too big. I just fail to see what is gained by knowing he’s small. I mean, if he runs the risk of being low birthweight, the best thing to do is carry him for as long as possible, which is exactly what I plan on doing anyway (not that I have much say).

And to be quite honest, I’m not sure he is all that small. I think he may be smaller than his brother (who was 7 lbs 11 oz and 20.5 inches — on the tall side, perfectly normal for weight), but he just presents differently. Maybe he was stretched out. My tummy definitely bulges to the right side instead of in the middle. (He’s sort of lying on his side — his butt is on the right side of my belly and his hands/arms/legs poke towards the left side of my belly. He’s head down.)

But because now I’m worried/wanna know what’s up I will present myself as requested at 1 pm tomorrow to have the, uh, 5th ultrasound for this pregnancy? (Ok, one or two of those definitely had to do with me being worried after my pair o’ miscarriages, and then the whole “short cervix” debacle but still…)

The worst part is that I see a *midwife* in part because I do not think I require that much medical care and because I am a non-interventionist patient. Is she just a very interventionist midwife, or would I be getting even MORE procedures with an OB/GYN? I’m really healthy! I could have this baby in the bathtub, if someone would throw in a few stitches afterwards! It doesn’t get easier than me!

In other obnoxious news, it is recommended that pregnant women get flu shots. If I get a shot now, it will protect both me and the baby for the flu season. (Which is good — you’d rather not give the baby his own shot.) So wouldn’t you think that my midwife/OBGYN would have access to the flu shot, which does not have a shortage this year?

Nooooooo….

She says I should see my PCP. Fine. My PCP is just down the hall. I drop in with fantasies of a “sure, sit right here and we’ll just jab you right now”. I mean, they do flu shots at Walgreens. How hard can it be.

Well, they have a flu clinic on the 27th (a day past my due date!) and they can’t give any shots before then. This is not helpful. I want the shot while the baby is internal, kthx.

So now I need to find a Walgreens or some place that has a clinic before then. Really, does following health recommendations need to be this hard?

GRUMP!

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