This was our first week of having twice-weekly assessments to monitor Norah's progress and see how she's handling the remainder of the pregnancy. Getting to see our baby girl multiple times a week sounds fun and awesome, right? We thought so too.
We should really know better than to assume anything.
Let's start with the basics. When I go to MNPP for these assessments, they do two things:
- A biophysical profile (BPP) – Ultrasound that measures heart rate, muscle tone, movement, practice breathing, and amount of amniotic fluid around baby.
- A non-stress test (NST) – Monitors strapped to my belly that record heartbeat, movement, and uterine activity. They're watching how Norah's heart rate changes in response to activity and rest, as well as any possible contractions I could be having.
This process usually takes about 1-1.5 hours. If any red flags pop up during the assessment I go to the Maternal Assessment Center (MAC) at Abbott for further monitoring. Being in the hospital provides the resources to handle an emergency delivery, should it become necessary.
Assessment #1 // Emails.
Are 'snow days' from adult life a thing?
No? Well, they should be.
Our normal 30 minute commute to the clinic took 1.5 hours because of the snow. Due to our delay, we wouldn't have time for all of the appointments (this was to be our second marathon). Because of the cut to our schedule, I told Lane to turn around and head to work about half way into our drive. It was just going to be some simple testing and I figured could handle it alone.
- Norah was her normal, active self. She was practically dancing on the monitor.
- After being head down since week 24, Norah evidently decided she'd had enough of that and was now breech. Lovely. Bring on the c-section conversation...
- Norah also decided not to show any practice breathing. The sonographer explained that babies don't practice breathe all the time, so it's fairly common not to see it.
- I officially had excess amniotic fluid. A normal measurement is under 25, and I was at 34. This can cause more uterine irritation, and in some cases such discomfort to the mother that fluid needs to be drained. The nurse said she was surprised I didn't look as big as some women with that much excess fluid, and that my belly wasn't super hard for being so stretched. So, as long as it doesn't put me in extreme discomfort, they'd just keep an eye on it.
NST - Everything was as expected. I was still showing an irritable uterus and some Braxton Hicks contractions, but Norah's heart was responding just as it should to activity and rest.
All in all, the assessment didn't go badly, but it wasn't great either. I don't know what I was expecting, really. That everything would magically be perfect? Maybe. I found myself more frustrated with the appointment than anything.
When I got to my car after the assessment, I checked my phone to see an email reminder for a Newborn Care/Breastfeeding class we had signed up for months ago.
What was the point of this class now? Newborn care? Norah could be spending her entire newborn phase in the NICU. Breastfeeding? My version of this natural feeding and bonding process will likely involve a machine, not my child.
Welcome the spiral of 'Why's. Why can't we have just one appointment where everything is normal? Why can't she have a normal newborn phase? Why is this happening to our little girl? Why is this happening to us? Why?
I called Lane and we talked through and then out of the emotional spiral.
Who knew one little email could cause such a reaction?
We cancelled our registration for the class.
Assessment #2 // Grey hair
The second assessment took place later that week, at one of the MNPP clinics closer to our house. I assumed this would just be another 1.5 hour appointment, so I told Lane he didn't need to come.
- Breech? No. Transverse (across the belly) sounds better. Yep - Norah had adjusted her position again.
- Her heartbeat was normal and she was her usual active self.
- Unfortunately, she still didn't show us her practice breathing, the little stinker. During the half hour the were waiting to see if they could catch it, I was pleading with God, "Please, just let her practice breathe. Please show a normal reading. Please don't give the doctors another reason to worry..."
- PS – Don't test God.
NST - The NST took place in a different room and on a different monitor than the BPP. As soon as I was hooked up to the monitor they saw Norah's heart rate had plummeted. They quickly had me roll from side to side (which causes her to move), and placed me on oxygen. They didn't tell me numbers, but I didn't need them. The audio of her heartbeat sounded terrifyingly slow compared to what had always been strong and steady.
The nurses quickly grabbed the ultrasound machine. I have never felt as truly hopeless or as afraid as I did in that moment – wrapped in wires and tubes, nurses prodding at my stomach with various monitors, just staring at Norah's slowly beating heart on the ultrasound. The image on screen brought me to tears.
Realizing my complete lack of control was painful. Just minutes ago I thought I could control the situation and just pray a normal result into existence. How incredibly foolish that seemed now, as Norah's life was being held in His hands. There was nothing I could do except trust God in the most honest, desperate and vulnerable way that I have ever experienced.
They didn't keep the ultrasound on for very long – just enough for them to verify it wasn't a malfunctioning monitor. With all the movement and oxygen, her heartbeat came back up and rested at a normal, healthy rate. I couldn't tell you how long the whole situation actually took — seconds, minutes maybe.
It felt like hours.
They monitored her while keeping the oxygen on, and then again without it for another hour. Her heart rate was perfect the entire time.
As soon as Norah was stabilized, they called in a perinatologist from the clinic at United. This doctor said her drop in heart rate could likely have been caused by her squishing the cord somehow. It happens like when adults hold our breath - once it gets uncomfortable we do something about it. He didn't think the oxygen or my movements had anything to do with her heart rate stabilizing. Norah just had to move off of her cord. He said that the way her heart reacted when it came back up showed no signs of her being or having been in real distress.
So, I had two options: I could go home and wait until the next morning to go into one of their locations for another NST, or I could go straight to the MAC at Abbott and do immediate additional monitoring.
After what just happened, there was no question – I was going to the hospital. There was no way I'd be able to sleep without knowing she was OK.
I called Lane on my way to Abbott. I was barely able to explain what was going on before I started crying. I was so scared.
Because I'd be there for about 4 hours, we decided he would come after work (which ended in 1.5 hours), unless I needed him sooner.
Sitting in that MAC room, with Norah's heartbeat as my background music playing just slightly louder than the bad tv I was watching, was a strange mix of scary and relaxing. I was terrified of her heart rate dropping again, but I knew I was in the best place possible if anything did happen.
After I was connected to the monitor, I didn't see anyone until Lane showed up. I didn't realize how tense I was until I was able to fully relax with him by my side. The nurses were watching her monitor from screens at the main desk, so being left alone was a good sign.
After the testing was done, the nurse reviewed the results and said, "These are beautiful, textbook results. Exactly what we want to see."
And with that, we were free to go.
Sometimes God teaches us things in difficult ways.
Was it painful learning to honestly trust that He is in control, and that we really have no say over this pregnancy? Absolutely.
Was the lesson necessary?
Without a doubt.
I think we're both going to have full heads of grey hair by the time Norah arrives.
Continue the story > #13 // Peaks and Valleys