At 24 weeks and 4 days, today we had our 24-week prenatal appointment with the OB. I met our new OB today for the first time, and I love her. She is so incredibly sweet and kind and warm…everything we were hoping for in an OB! What a difference from our old OB! She confirmed that our recent 24-week ultrasound with radiology showed everything was normal and the twins are growing concordantly. She also mentioned that she likes twin pregnancies to have the ultrasounds through radiology every four weeks to make sure both twins are growing appropriately. Gee, finally folks are agreeing on the plan! She did a quick ultrasound in the exam room to see how they were positioned and check their heart rates. Baby A, although at every scan before this one has been head down, was head up, and A’s heart rate was in the 130s. Baby B was still head down, though in a more transverse-ish orientation that on the last scan, and B’s heartrate was in the 150s. The OB said babies will normally eventually decide on a position and mostly stick to that – in singleton pregnancies it usually happens by 37 weeks, but in twin pregnancies it happens around 35-36 weeks. Hopefully they’ll both settle on head down so we can at least have a shot at a double vaginal birth (ideally).
(She also gave us printouts of the radiology reports with all of the measurements from the 20-week and 24-week ultrasounds and those posts have been edited to add all of the measurements. In case anyone is interested. No hard feelings if I’m the only one.)
As we were leaving the appointment, they had us schedule a couple more future visits, including one in late April and one in May. What’s ridiculous though is that they required us to make an appointment in May…after the 38 week mark. We were told at the Expecting Multiples Class that it’s hospital policy to induce twin pregnancies at 38 weeks. We told them that, but “I still have to schedule it,” she claimed. Whatever. If they’re still cooking at 38 weeks, and we can get away with not being induced, sure, we’ll be there. Otherwise, you need to improve your interdepartmental communication.
After the appointment with the OB, we did a quick “Preterm Teach” session with an RN where they tell you what signs to be aware of that could indicate preterm labor. What I thought the funniest part of the whole session was that the little list they give you are virtually all things that pregnant women experience, even if they aren’t in labor: menstrual-like cramps, low dull backache, pressure, abdominal cramping, vaginal discharge, and “feeling bad” (how vague is that?!). But I guess what’s most important is a sudden change in severity or frequency of those things. Still, when she started to list them, I thought, “Gee, guess Molly’s been in preterm labor for about 20 weeks then!”
From now on, Molly is supposed to take an hour every morning and an hour every evening to lie down, keep her hands on her belly, and monitor for contractions. If there are six or more contractions in an hour, or any contraction lasts longer than 35 seconds, then that’s cause to call perinatal services, who will then most likely tell you to go to the hospital to be evaluated. So, starting tomorrow morning, we’re both going to get up an hour earlier – Molly to do her preterm monitoring and me to exercise (which I’ve been doing in the evening, but I’m hoping that getting up early with Molly will motivate both of us to do what’s best for our respective bodies). Also starting now as part of the preterm labor monitoring program is a weekly phone call from a preterm labor nurse where they ask you a ton of questions about preterm labor symptoms. I guess all of these are good things, it’s just so scary to think that Molly will definitely begin having contractions…and soon! And that’s totally normal, especially with twin pregnancies…but eventually it will be “the time.” Guess we should pack a hospital bag and keep it by the door, because we might not know if we’re coming home or not!
Once Molly reaches 28 weeks, and before our next appointment with the OB (just after 28 weeks), Molly has to have a CBC done to check for anemia and the glucose challenge test to screen for gestational diabetes. Here’s to hoping everything stays normal!