Tuesday 14 October 2014

35 Weeks Pregnant With Twins - Birth Plan, Pre-eclampsia

I'm getting quite nervous! ;)  I'm 35 weeks 1 day today and I have mixed feelings! I just can't wait to see my little babies but on the other hand, I need to try to hold them for as long as I could to ensure that they are able to birth at full term with no or little complications.

Well, I have changed my gynae. I find that I am not too comfortable with Dr Jason Lim who is not agreeable with my birth plan or rather any birth plan for that matter. It was rather depressing as I had always highly respected Dr Jason. Maybe we just don't click in this doctor-patient relationship after all.

Anyway, our first appointment with Dr Tan Ee Ping of CT Woman & Child Specialist Clinic at Seri Kembangan was on 11/9/2014. I was 30 weeks 3 days then. It was a pleasant first meeting with Dr Tan. She is a certified hypnobirthing practitioner and I know she definitely supports natural vaginal births.

However, the moment she saw my history of all my previous pregnancies, she frowned. "These babies are very precious to you, aren't they?" she said, looking straight into my eyes. I was suddenly being painfully reminded that this is indeed my fifth pregnancy. I sighed and nodded while stealing a look at hubby. With that in mind and despite all the benefits of having a vaginal birth, Dr Tan somehow indirectly suggested that we have a cesarean birth instead of a vaginal birth so as to 'transfer' the birth risks, if any, to me and not the babies. The reason being there is always a calculated risk for vaginal birth on baby B and this risk will be eliminated if I were to go for a cesarean birth. Well, we have soon decided that we shall proceed with cesarean birth after all.

The scan showed that both babies were finally head-down, side by side. However, both babies were still slightly behind their gestational age with Baby A weighing 1.3kg (2 weeks behind time) and Baby B weighing 1.9kg (1 week behind time). Surprisingly, Dr Tan commented that they were actually of a good size for twin babies. Both babies' heartbeats were in the region of 150s.

Dr Tan also managed to run through our draft birth plan with us and we are happy that she is agreeable to accommodate to almost all of our requests. Well, as we have already anticipated a cesarean birth from the beginning, our birth plan is just a very basic and simple one (I think! Haha!). My main concern is to have a gentle cesarean birth which allows me to have skin to skin contact and bonding time (however brief that may be!) with my babies in the operating theatre itself. The other request which I truely appreciate is for our babies to room-in with me during my stay at the hospital to enable me to fully breastfeed them on demand. I was so happy that Dr Tan is agreeable to these two main requests. :)

Our second appointment with Dr Tan was on 25/9/2014. My blood pressure was 128/70. A bit high according to the nurse. The scan still showed that both babies were smaller than their gestational age although they remained head-down (Baby A was on my right while Baby B was slightly higher on my left). Dr Tan laughed saying that maybe they both wanted me to deliver them naturally through vaginal birth. Baby A weighed 1.55kg (2 weeks behind time) with heartbeats at 140 while Baby B weighed 2kg (1 week behind time) with heartbeats at 144. Everything seemed good so far except that both my feet were swollen. Dr Tan assured me that the swelling is fine so long that it doesn't hurt. In fact, they may continue to swell even more!

I was advised to go on a low sugar diet because I'd gained weight too rapidly. I'd put on 3kg in 2 weeks! Oh my! So, I'm supposed to limit or avoid foods such as rice, noodles, breads, cakes, biscuits, fruits (yes, fruits!), Milo and soy drinks! I must try to eat more vegetables and meat. How could I possibly survive with this diet?!

The birth plan was amended as agreed by Dr Tan. Dr Tan affirmed all our requests and signed our birth plan. Yaaay! She also gave us the emergency hospital admittance form...just in case. However, she added, in the event of emergency and if I have dilated say maybe to a 7cm, then I may as well go for a vaginal birth! How nice! Dr Tan further commented that my cesarean wound may not heal as nicely as some ladies because there are already stretch marks all over my tummy. This is sad...hmm...

Meanwhile, as we have no intention to choose any auspicious date for the births of our little ones, Dr Tan chose two dates for us; one on my 38th week if I could hold that long and the other on my 37th week. :D

Last Thursday (9/10/2014) was my 34th week 3 days. Babies were good and still in head-down positions. Baby A weighed 2kg (about 2 weeks behind time still) with heartbeats at 144 whereas Baby B weighed 2.4kg (on track!) with heartbeats at 141. I was very happy with their progress as they were then at least 2kg each!

However, I was suspected of mild pre-eclampsia. I couldn't believe my ears! My blood pressure was 132/78 and traces of protein (very low content) were found in my urine. There was nothing much I could do except to continue with the low-sugar diet and to see Dr Tan again in a week's time to repeat the urine test and to check on my blood pressure. A 'vaginal swab' sample was also taken to be tested and I can expect the results in a week.

Pre-eclampsia is a serious condition and in severe cases, it could even cause life-threatening problems to both myself and our babies. In a recent development, pre-eclampsia is believed to be caused specifically by a problem with the placenta. The mother's body then responds by trying to deliver more oxygen to her baby by increasing her blood flow to her baby at the expense of her own health, thus resulting in the mother having high blood pressure (blood vessels constrict) which then affects her organs such as liver, kidneys and brain.

Should I be diagnosed with pre-eclampsia, Dr Tan insists that I have to arrange for delivery as soon as possible and not to wait until the condition worsens, but after getting another two doses of Dexamethasone to help mature the babies' lungs. I don't know what to say.

That was really too much for me to digest in a day! Pre-eclampsia?! Gosh!

Now I really have to pack my hospital bag...

No comments:

Post a Comment