We have officially entered the fetal period. Yay for developmental milestones! Last week we had our last ultrasound with the RE, and saw our baby dancing around for the first time (my husband and I spent a while trying to dance like our baby — he claims that our baby appears to have inherited my dancing ability, which I do not think is a compliment!). Yesterday we were at our local OB for a quick check-in and we heard the heartbeat on a Doppler for the first time at 10w1d. It’s nice to know that now we can go for a quick Doppler check up whenever we’re freaked out (OK, whenever I’m freaked out, since I’m about ten times more likely to be freaked out about the baby dying at any given moment than my husband).
Rationally, I know that entering the fetal period is a big deal and a really good thing. There’s this study that says that for low-risk women, hearing a heartbeat at nine weeks means a 0.5% chance of loss for the rest of the pregnancy (I’m not low-risk, but it’s still reassuring that our odds of miscarriage due to chromosomal abnormalities are low at this point). I also like to look at this page in early pregnancy, which combines data from two studies to interpolate a sort of day-by-day loss risk for women in their first pregnancy (again, not me), which levels out to a constant, low baseline around weeks 9-10. All of these numbers seem to be reflecting the reality that successfully making the transition from the embryonic to the fetal stage is a major developmental milestone that sharply decreases your risk of miscarriage due to chromosomal abnormalities. So, yay!
That doesn’t mean I haven’t found things to worry about, of course. 🙂 At our appointment with the RE (8w6d), our baby’s heart rate measured 185bpm. When I asked the RE if that was good, she said, a bit distractedly, “We like to see it under 190.” This, of course, freaked me out because I’d never heard that a heart rate could be too high before, so naturally instead of thinking to ask the expert in the moment my anxiety built until I went on a great Google spree that evening. Turns out there are generally two reasons why you might be concerned if your baby’s heart rate is too high: (1) it could indicate that the baby is experiencing distress of some sort (usually later in pregnancy), and (2) abnormally high fetal heart rates in the first trimester are correlated (though obviously not perfectly) with chromosomal abnormalities like Down syndrome. I found a bunch of charts showing the typical fetal heart rate ranges and how they change over time (the fetal heart rate generally declines from about week 8-9 until the end of the trimester), but they all started at 10 weeks (or a crown-rump length longer than our 8w6d measurement) so I had to extrapolate backwards from some pretty noisy data. It did indeed look as though 185 was on the high side of normal — somewhere close to the 95th percentile (using my extrapolated estimate). So I spent a week freaked out about chromosomal abnormalities, despite the fact that I was using fetal heart rate charts to evaluate the heart rate of an embryo.
Yesterday at 10w1d the doctor measured the heart rate at around 170 — when I went to put that measurement on the chart (no extrapolating this time!), it was right around the 50th percentile. Phew! (Yes, I realize I’m obsessing unnecessarily.) This doesn’t mean that I’m totally over my fear of chromosomal abnormalities, but I sent off my NIPT kit yesterday and should get the results back sometime around the date of our nuchal translucency screening a week from Thursday, so hopefully I’ll get some reassuring news in the next two weeks. It also helps that my mom mentioned when she dropped off the kit that they haven’t yet had any patients from her office come back with a positive NIPT result yet. Of course, I can’t help but think that it’s only a matter of time so maybe I’ll be the first! (<– That is some useless, illogical thinking right there.)
Whatever the results, we’ll also know the sex of our baby when the NIPT results come back. I’ve read enough about pregnancy after loss to know that many loss moms have complicated feelings about finding out the sex of a new baby after a loss — some are really, really hoping for the opposite sex, so that they can get a clean start and feel less like they’re “replacing” the baby that died, while others are really, really hoping for the same sex, so that they can fulfill the dreams of mothering a little boy or girl that they had with their previous baby. Of course, my husband and I just want a healthy baby, and we will be thrilled with whatever the coin toss turns out to be. But if I’m being honest (and we’ve talked about it, so I know my husband feels the same way)… we both wanted a girl, and were so excited when we found out our first baby was a girl. Maybe it’s because I was the only daughter of a single mom, but I really want that special mother-daughter bond, and I also seem to find girls easier to relate to than boys in general. I’m sure that would change if I had a son, and I know I’d love him to bits with all of my being. As I told my husband, there are some pretty great guys in the world, after all, and if our son is anything like my husband, I’m sure he’ll be one of them. 🙂 I do feel bad even admitting that I have a preference, but I have to be honest — having that dream of a daughter to raise snatched away so abruptly in our first pregnancy was really hard, and it’s making me nervous about finding out the sex this time. Mostly because I’m afraid of my own reaction.
To end on a (somewhat) lighter note, one curiosity I had going into this pregnancy was whether I’d start “showing” at the same time or earlier than in my first pregnancy. There’s lots of information out there about when you start showing in a first pregnancy compared to a second, and everyone says it’s several weeks to a month earlier in your second pregnancy… but what if your first pregnancy was only half-baked? I’d just about made it to the halfway point when our daughter died, so my uterus only got stretched out partway. It’s hard to say for sure, since this pregnancy has been different than the last (I’ve been on progesterone, for one thing, which increases bloat), but I do think I’m starting to show sooner than I did last time. At some point this week, I decided that I’m about two weeks ahead of how big I was in my first pregnancy, based on how I look in the bathroom mirror before I take a shower and how my clothes are fitting. I’ve hardly gained any weight this time around — 1-2 pounds at most, compared to probably 3 or 4 by this point in my first pregnancy — but still I can definitively see my belly starting to poke out as things get crowded in there (the internet tells me that my baby is the size of a kumquat this week, and my uterus is the size of a grapefruit — why is it that everything about pregnancy must be compared to edibles?!).
So, the short version is that things are going really well so far, and we’re very excited to have made it to the fetal stage. We’re really just waiting for the flurry of activity at 12 weeks, when we’ll find out our chances of chromosomal abnormalities, and in the meantime trying to enjoy our little dancing bean!