Reflecting on His Faithfulness

Tomorrow is another big day for us, as we have what is possibly our last regular OB visit of this pregnancy.  Despite Thursday's amazing appointment with the perinatologist, our OB has put us on the books for a Thursday, May 28th, cesarean; and tomorrow's office visit is our last chance to discuss his decision with him.

I've spent a lot of today thinking about what questions I want to ask of my doctor while simultaneously clinging to the instruction and promise in Philippians 4:6-7:  "Be anxious for nothing, but in everything by prayer and supplication with thanksgiving let your requests be made known to God.  And the peace of God, which surpasses all comprehension, will guard your hearts and your minds in Christ Jesus."

As I think about my questions/concerns/fears regarding this May 28th deadline and the passing of yet another day which brings us closer to it, I can't help but think about the many prayers regarding this pregnancy that God has already answered.  I went back tonight and read a couple of my older blog posts and was greatly encouraged as I revisited--and realized--some of the things that God has already done.

I hope that anyone reading this tonight will also take the time to visit (or perhaps revisit) these posts, and that as you do so you, too, will see God's hand at work.  Below are the links.

God's Purpose Will Prevail
Making My Requests Known

"The Magic Formula"

Praise God from whom all blessings flow!  Tonight I am sitting at home, 36 weeks pregnant with healthy, growing twins!

This morning started with a mix of emotions as Travis and I added last-minute items to our hospital bag, loaded the van, and headed to our ultrasound appointment prepared to stay and have our babies delivered this afternoon.  While I felt prepared for whatever the ultrasound might indicate, I warned my husband that I was sure I would cry no matter what the results.

Anxiety started to build as we sat in the waiting area of the perinatology office.  I looked around the room at the other couples waiting to be called back for their ultrasounds, and I wondered if we were the only ones with reason to feel anxious.  They all looked so calm and worry-free.  I probably looked the same on the outside.  But on the inside my tummy was doing flips as I wondered what outcome a few simple measurements would determine for us.

We didn't have to wait long before we were called back, and the ultrasound itself seemed to go rather quickly, too.  Measurements completed, the technician at last reported our babies' weights:  Baby A, who measured 3 lbs. 14 oz. ten days ago, is now measuring 4 lbs. 7 oz (which happens to be the cutoff point for avoiding an automatic trip to the NICU!); and Baby B, who measured 4 lbs. 12 oz. ten days ago, is now measuring 5 lbs. 8 oz.!  Pleasantly surprised by our babies' growth and praying it would be enough for the perinatologist to grant us more time, we headed to another room and waited for her to join us with her decision.

After what seemed like forever, the perinatologist at last knocked at the door and announced as she entered that she was going to let us pick our date--she was not going to make us have our babies today!  (I think this is the point where my promised tears appeared--tears not of fear or disappointment but of relief, thankfulness, and awe of my God.)  We discussed the babies' measurements and the fact that while they are both still small (Baby A is in the 1st percentile and Baby B in the 26th), they are growing and doing well!  She felt that waiting even two more weeks (until my 38th week) would be safe as long as my health, fetal movement, and non-stress tests remain good.  At some point during the conversation she made the comment, "Every thing is just going your way today!  You guys must know the magic formula."  I looked at my husband and smiled with thanksgiving in my heart as I thought to myself, Yes, we do.

As we were heading out the door at the conclusion of our consultation, the perinatologist added, "You know, you've made all the cutoffs for the NICU.  You'll take your babies home with you at 37 weeks."  To this I replied, "Praise the Lord!" and I watched as her face lit up.  She broke out in a smile, lifted up her eyes, and started waving her hand in the air in a praise to God as she said, "Oh, yes!  That's right!"  My new-found Sister in Christ gave me a hug, and I said, "That's the Magic Formula."  We both smiled and headed down the hallway together in an attitude of praise.  You see, I knew that no matter what happened today, it would be for the glory of God; but I didn't know it would be so apparent.  Today was a true testimony to Him, and I am so blessed that I got to be a part of it.  As this story continues to unfold, I pray that God will continue to receive the glory due His Name!

A Tentative Plan

Yesterday, a week after learning that our Baby A's rate of growth seems to be dropping off due to her having a two-vessel cord, we were finally given a tentative plan for the timing of our babies' births.

After yesterday's routine non-stress test (which went well!), I stopped by the perinatologist's office to inquire as to whether she had consulted with my OB.  To my surprise, I got the opportunity to actually speak with her briefly and found out that she had indeed passed her recommendation on to my OB group last week, but the information had apparently not yet made its way back to my specific doctor (which is why he didn't know anything at Friday's appointment).  I told her that my doctor would probably be contacting her to discuss the possibility holding off on the c-section another week, and she said that depending on what this Thursday's ultrasound shows, that could be a definite possibility.  She went on to say that she suspects we will be able to hold off another week, but she needs to see another ultrasound to make sure.  Basically, we need to see an adequate amount of growth in Baby A since the time of our last ultrasound to ensure that waiting another week is in her best interest.  I left the perinatologist's office both encouraged by her optimism and a bit confused by her change of tune.  After all, last week she had been dead-set on ending this pregnancy at 36 weeks (this coming Friday) and had even said that nothing would make her change her mind.

Later in the day I got a call from the perinatologist's nurse and found out that she had called my OB and that they had come up with a tentative plan.  They had agreed that if this Thursday's ultrasound looks okay, we will schedule a c-section for next Thursday, May 28th (my doctor's closest on-call day to me being 37 weeks).  But if the ultrasound shows cause for concern and indicates the need for an as-soon-as-possible cesarean, our babies will be delivered this Thursday after the ultrasound.

For the past week we have been praying for wisdom and clear guidance; and when Travis and I talked yesterday about how my upcoming days should be conducted, we agreed that between now and Thursday I should be resting and eating lots of protein in hopes of boosting Baby A's growth and thereby buying us another week.  However, we are praying that if our babies do indeed need to be born this week that labor will start on its own (before Thursday!) and in spite of my not taking measures to naturally induce it.

Somehow, despite all the uncertainty surrounding us, God has given me peace that surpasses all comprehension (Phil 4:6-7).  My desires for a natural childbirth and for babies too strong and healthy for the NICU have not changed; yet somehow, in the face a possible cesarean and the birth of a baby too small to avoid the NICU, God has given me peace.  I don't understand it, but I have it; and I am thankful.  I continue to cling to the certainty of His character and to His promises, knowing that nothing is impossible for Him, knowing that His purpose will prevail, knowing that He is not bound by my circumstances, and knowing that He hears my prayers and cares for my concerns.  Instead of being anxious, I have purposed to continue to make my requests known to Him and to thank Him.  Instead of worrying, I have purposed to believe Him.  Instead of trusting in our plan, I have purposed to trust in His plan, whatever that may be.  No matter what happens, may God be glorified.

05/15/09 OB Appointment and Prayer Requests

This morning was my first OB appointment since Monday's ultrasound, and it didn't go quite like we expected.  Better or worse than we expected?  I guess I'm not sure!... :-)

We didn't get far into the appointment before it became apparent that everyone was not on the same page.  Right off the bat, the nurse informed me I would be getting my Strep B test done today.  I told her I had already had that done last week and was expecting to get the results today, so she looked it up and recorded the result in my chart (Negative!  No penicillin during labor this time around!).  I then told her that I would like to have my cervix checked (I decided on doing this after receiving the news that we would be planning a cesarean for next Friday), and while I could tell she wasn't convinced this was necessary, she noted my request and handed me the lovely white "sheet" before leaving the room.

When my doctor came in he expressed approval of my "skinny ankles" and of my making it to 35 weeks.  He then checked my cervix and, upon detecting no dilation and only slight thinning, he exclaimed, "You're gonna do this!  You're gonna make it to 38 weeks!"  (Thirty-eight weeks is the point past which they don't like to let twins go because of increased risks and higher infant mortality rates.)  Pleased but confused by his comments, I asked, "Have you talked to the perinatologist?"  "No..." came the response, so Travis and I proceeded to summarize what she had told us following Monday's ultrasound (the results of which had not even been sent to the OB office).  We told him of the perinatologist's concern that Baby A is not growing well because of her 2-vessel cord, of the 18% weight differential between the two babies, and of the admitted possibility for error in Baby A's measurements due to her position (the full circumference of her head can no longer be measured because she is vertex and super low) and due to the tendency of the technician who did the scan the time before to over-measure (thus creating the appearance of insufficient weight gain).  Based on this information alone, our doctor seems to be thinking that there is not a strong enough indication for taking the babies early.  He said he would call the perinatologist and then call me, and we went on our way, more confused than ever.

I got the promised call from my doctor not long after returning home from my appointment.  He said he had been unable to reach the perinatologist thus far and was going to keep trying throughout the afternoon.  I told him that I really hoped he could reach her yet today because I was feeling so much in limbo--confused by the differing opinions and hoping his opinion is the right one since I want to carry these babies as long as possible.  We had a little further discussion about the fact that ultrasounds done so close together are not reliable, that our NSTs and kick counts show that both babies are doing well, that these are two babies in two separate sacks who should not be compared to each other, and that I tend to have small babies anyway (Abel was 7 lbs. 1/2 oz. at 40 6/7 weeks, and Amariah was 5 lbs. 13 oz. at 39 4/7 weeks).  He suggested that we talk to the perinatologist about waiting until 37 weeks to take the babies (sort of a compromise between her 36-week suggestion and his 38-week "limit"), and I told him I just want to go as long as is possible and safe for the babies.

A second phone call from the doctor later this afternoon informed me that he still hadn't been able to reach the perinatologist, so it will be the beginning of next week before we know anything more.  In the meantime, we wait and wonder whether or not we should be employing some natural methods of induction; and as we wait, we pray that God will grant us wisdom and clear guidance for the coming days/weeks.

If you would like to come alongside us in prayer, these are the specific requests we are making known to God.

• Lord, please allow our babies to remain in the womb until they are both truly ready for life outside it.
• Please cause labor to start spontaneously and in Your time so that we might avoid having a planned cesarean.
• Give us divine wisdom and clear guidance as we make decisions concerning the (natural) induction of labor and the selection of a cesarean date.
• God, please cause Baby A to grow at the appropriate rate in spite of her 2-vessel cord so that both she and her sister would be born at a sufficient and healthy weight.

In conclusion, I just want to say that the entirety of this pregnancy has been to me a source of absolute joy.  I view my babies as nothing less than a double blessing, and for that blessing I praise and thank God with all of my heart!  May God finish the good work He has started, and may He alone be glorified!

Psalm 20

Last night I read Psalm 20 and was greatly encouraged by this prayer that so closely resembles my own.

1May the Lord answer you in the day of trouble!
  May the name of the God of Jacob set you securely on high!
2May He send you help from the sanctuary
  And support you from Zion!
3May He remember all your meal offerings
  And find your burnt offering acceptable!

4May He grant you your heart's desire
  And fulfill all your counsel!
5We will sing for joy over your victory,
  And in the name of our God we will set up our banners.
  May the Lord fulfill all your petitions.

6Now I know that the Lord saves His anointed;
  He will answer him from His holy heaven
  With the saving strength of His right hand.
7Some boast in chariots and some in horses,
  But we will boast in the name of the Lord, our God.
8They have bowed down and fallen,
  But we have risen and stood upright.
9Save, O Lord;
  May the King answer us in the day we call.

Oh, God, how I pray that You will grant me my heart's desires.  I know that You hear my prayers and that You care for me, and I pray that You will fulfill all my petitions.  In You will I rejoice, and in Your name will I boast.  May You be glorified, oh Lord, my God!

05/11/09 Ultrasound

Well, it sounds like we might be having these babies no later than next Friday, May 22nd, the day I turn 36 weeks pregnant.  Today's routine ultrasound revealed that Baby A's two-vessel cord is beginning to cause an issue with her growth.  Weighing in today at a mere 3 lbs. 14 oz. and measuring closer to the size of a 30-week baby than a 34-week baby, she is now being classified as having intrauterine growth restriction (IUGR).  Although she is still growing and otherwise healthy, it is clear that her rate of growth is beginning to slow.  As a result, the perinatologist who reads our ultrasounds is recommending that we not push this pregnancy past 36 weeks with the thinking that Baby A will be able to grow better outside the womb than in and that we will be eliminating the risk of the restricted growth getting worse.  The perinatologist did express that it would be preferable for my body to naturally end this pregnancy by spontaneously going into labor before next Friday (which is my fervent prayer!) than to end up in a planned cesarean on that day, but she also expressed some doubt of that happening due to the fact that my body has previously endured both a 40 week 6 day pregnancy and a 39 week 4 day pregnancy.

I think I took all of this somewhat disappointing news pretty well, but the tears started coming when we started talking dates.  The doctor compassionately asked if I was scared of my babies being born too early, and I nodded yes before adding that much of my emotion was also coming from my deep desire for a natural childbirth.  Despite my momentary disappointment, I know that God is the same no matter what, and I know that nothing is impossible for Him; and I am greatly comforted by these promises as I prayerfully wait to see how this story will end.

In the meantime, my instructions are to rest (to enhance blood flow to the babies), to put a little extra protein in my diet (to enhance growth of the babies), and to go back for bi-weekly NSTs (to monitor the well-being of the babies).  I am fervently praying that God would keep both of our babies in good health until the time of their birth and that He would even miraculously enable Baby A to have a growth spurt in the next week and a half.  Whatever happens, may He be glorified to the utmost!

My Baby Bump

Okay, many of you have been asking for it, so here it is!  I have finally added my current belly picture to the sidebar, and I will do my best to update it weekly!  I hope you enjoy the viewing as much as I enjoy the growing! :-)

Love,
Angela

05/08/09 OB Appointment

I just returned home from my 34-week OB appointment!  I feel so blessed by each passing week of pregnancy and more beautiful the bigger I get.  I find myself smiling at my large baby bump as I think about the reasons for its size.  I even caught myself smiling as I looked at the newly forming stretch marks on my tummy this morning.  I never thought I would react that way to stretch marks--and granted, they really aren't very bad--but now that they're there they seem to me a sort of testimony to the goodness of the Lord in strengthening me to carry my babies long enough to get stretch marks! :-)

Even my doctor expressed joy in my progress, exclaiming, "Thirty-four weeks!" as he walked through the exam room door this morning.  He then went on to say, "You know... most twins deliver between 34 and 36 weeks."  Praise God that I have reached the point at which most twins deliver!  Although, I pray I might go even longer!  May God bring these babies forth only when they are both truly ready to greet this world!

In other praiseworthy news, I gained only 1.2 lbs. over this past week!  They say twins will each gain 1/2 to 3/4 a pound a week at this point in pregnancy, so I think I can claim that only the babies gained weight this time around. :-)  My blood pressure has remained steady at the elevated but normal level it's been for the last couple weeks, and I'm still having no issues with swelling.  The doctor (the same one I saw last week) measured my uterus at 38 cm, 1 cm larger than last week.  I think my normal doctor would have probably measured me bigger; but regardless, growth did occur, and for that we praise God!

As for the babies, they seem to be happy and thriving in their safe and peaceful environment.  They have been passing their daily kick count test with flying colors, and their heart rates remain good (Baby A at 148 bpm and Baby B at 145 bpm)!  We'll check in on them again tomorrow with a routine non-stress test and on Monday with a routine ultrasound.  I look forward to seeing how much they've grown in the past couple weeks!

At next Friday's OB appointment I will find out the results of today's Strep B test and will possibly get my cervix checked.  I have mixed feelings about that--part of me wants to know if I've started to dilate at all, but another part of me wants to decline the check and not risk stirring things up.  After all, I'll still be only 35 weeks along.  I guess I'll be praying for wisdom to make the right decision!

I have to tell you, this pregnancy (and all the circumstances surrounding it) has been an amazing and beautiful thing.  I feel like every detail of it is evidence of God's hand at work in response to the many prayers that have covered us.  I am so excited to watch as this story unfolds; and I pray that no matter what, God will receive all the glory for the things He has done!

Just Because I'm Having Twins...

Lately, I am finding myself thanking God for allowing me to "beat the odds" by remaining pregnant yet another week.  Careless assumptions and over-zealous doctors' orders could easily make a mother-of-twins-to-be begin to feel doomed--doomed to a cesarean, doomed to a premature delivery, doomed to a stay in the NICU.  Realistically, yes, these outcomes seem to occur more frequently for twins than for singletons.  But what is the point of being so pessimistic, as if it isn't a natural or blessed thing to have twins?  I get so tired of the assumption that I will indefinitely deliver early just because I'm having twins, that I will indefinitely need/want a repeat cesarean just because I'm having twins, that things will indefinitely go awry at the 38-week mark (if I'm one of the "lucky" ones to make it that far) just because I'm having twins.

I feel like the whole of this pregnancy has been treated differently just because I'm having twins.  Routine ultrasounds every two to four weeks; routine non-stress tests every week; and talk of trying to make it to 33 weeks, hoping to make it to 36 weeks, and not being allowed to make it past 38 weeks all make me wonder why this pregnancy is treated like a rare, unnatural, risky thing... just because I'm having twins.

Don't get me wrong.  A part of me looks forward to seeing my babies so frequently via ultrasound, and all of me is reassured when my ultrasounds and non-stress tests testify to the favorable growth and development and health of my babies.  But at the same time, a part of me longs to be treated like this pregnancy is the natural, blessed thing that I know it is.  (Many of you have indeed encouraged me in this manner, and for your prayers and optimistic support I am so thankful!  It's really just the general treatment of a twin pregnancy of which I speak, so please forgive my blanket statements.)

Thankfully, my hope and trust is not in the careless assumptions of man or in the (what at times seems to be) over-zealous protocol of doctors.  Instead, my hope and trust is in the God who opened my womb and filled it with two blessings, who hears my prayers, and who already knows the end of the story.  It is from Him my joy and optimism come, for I know that His character and His plan does not change just because I'm having twins.

My Husband

Today I am thinking about my husband and all the reasons I am so thankful to be his wife and the mother of his children....

• Travis loves, fears, and obeys God.
• He is growing in his relationship with God and encourages me to do the same.
• He lives with an eternal outlook.
• He abhors what is evil and clings to what is good.
• He loves me unconditionally and serves me sacrificially.
• He knows me better than I know myself... and he loves me anyway.
• He has a good relationship with our children, and they know how much he loves them.
• He takes seriously his role as head of the household, strongly and prayerfully leading us with much wisdom.
• He looks out for the best interest of his wife and children.
• He works hard to provide for his family, but he never puts his work ahead of us.
• When he is here, he is really here, engaging with me and the kids and building memories that will never be forgotten.
• When he sees a problem he is quick to fix it.
• He manages our financial household responsibly.
• He is unselfish with his time and energy.

Travis, I love you and respect you as a man, a Brother in Christ, a husband, a father, and a friend.  I am so blessed to be your wife, and our children are so blessed to be your kids.  I will never stop thanking God for giving you to me.

05/01/09 OB Appointment and NST

Thirty-three weeks pregnant with twins and counting!  This afternoon's schedule was filled with another routine OB appointment and non-stress test, and I am thankful to say that all is still going well!  Maybe a little too well in the weight gain department--I am a little disappointed to say that somehow I put on another 5 1/2 pounds in the past week, putting my total weight gain at about 41 pounds.  A maximum of 45-50 pounds is recommended for a twin pregnancy, and it seems I am approaching that number a little too quickly!  I'm not having any issues with swelling, though, so I guess that is a good sign.

My weight isn't the only thing going up.  My blood pressure seems to be slowly rising over the past few weeks, as well, running a little high for me but still in a normal range.  The doctor commented that it is normal to see an increase in blood pressure in the latter weeks of a twin pregnancy; and while they will keep an eye on mine if it continues to rise, he isn't at all concerned at this point.

The only measurement that (seemingly) didn't go up this week was my fundal height.  Last week I measured 38 cm and today only 37 cm.  I questioned the doctor about this, and he basically said it's just a matter of which doctor does the measuring.  I'm fairly certain that I did indeed grow this past week, and I think it's unfortunate that because I saw a different doctor than usual I can't really accurately track that growth.  Apparently, it doesn't matter all that much to the doctors, though, since the twins growth is being tracked via ultrasounds and not by fundal height measurements.

Remember yesterday's post?  We think that Baby B has very recently turned into more of a head-down position, and I was hoping to have that confirmed by the doctor today.  However, when I asked if he could tell by feel where the babies are positioned, he simply said it's too hard to tell with twins and didn't even try.  Oh, well....

Overall, the doctor was very optimistic about the way my pregnancy is going.  He said that if there is going to be a problem with a pregnancy it has usually become apparent by this point and that he has no concerns for mine (pregnancy, that is).  Comments like these are, of course, encouraging and empowering; but they also drive me to praise God for my health and that of my babies!

After my OB appointment I spent two hours on the Labor & Delivery floor for the second of a series of weekly non-stress tests.  Just over an hour of that was spent on the monitors (both babies looked great!), and the rest of the time was spent waiting in the triage room for the first available nurse to get me hooked up.  Perhaps God ordained that extended period of waiting, for in the room next to me was a woman 36 weeks pregnant with twins who was about to be wheeled back for an emergency cesarean.  As I overheard the details of her situation, I was able to cry out to God on behalf of her and her babies and then to spend some time in prayer for my own babies.  How thankful I am to have a God who hears my prayers....