Pregnancy diary: week 24 – BOGOF on scans (except I didn’t pay a thing)

Cute little nose showing, as baby looks right at the camera 😉

It seems like ages ago that I sat in the waiting room for our (what turned out to be) 13 week scan and saw a poster asking for pregnant mums to take part in junior doctor training by having an extra scan. Now, 11 weeks later, I’ve actually had the scan. In fact I ended up having two, each on consecutive days! When I arrived for the first on Tuesday, the lady checking me in rather gingerly asked if I might possibly have time to come again later in the week. She looked quite desperate to fill the slots (I can only assume not enough people had signed up, or had cancelled last minute). So I couldn’t resist agreeing to come again – I’ve been there, done that, and bought the desperate person t-shirt myself, trying to get as many participants as possible for my PhD experiments and for the project I’m currently working on in my job. After all, I’d get to see baby again, and I knew Tom was having a random day of annual leave on the Wednesday so I could get to work earlier and take a longer lunch break for the scan. There was a small remuneration and free car parking involved (not that I used it on the second day as I was on my bike), but that wasn’t enough on its own to attract me to help out. This is the kind of thing you have to not mind giving up your time for.

Scan 1

The scans were taking place in a training suite, not at the usual maternity hospital ultrasound department. It was actually a lot easier to find than the usual place, which I still find difficult to find in the hamster maze of corridors that make up the hospital! I was greeted by the above-mentioned lady and shown to a waiting area. A short time later I was called through by a young doctor (she looked younger than me – she probably was, it’s possible, even though this makes me feel old). I was greeted in the scanning cubicle by another junior doctor, two sonographer midwives and a fetal medicine consultant (who incidentally works at the Norfolk and Norwich hospital where I was born – doubt he was there then, again he looked too young…).

After a few basic questions like how many weeks pregnant I was, the first junior doctor got on with the scanning. Her first task was to figure out what position baby was lying in (head down and back to my left side), and showed the consultant what she’d concluded using a Winnie the Pooh stuffed toy. She was right. Then came a good look at the head. They talked amongst themselves about various things, most of which I understood, even though they were tossing about names of brain parts like they were piece of fruit in a bowl: bla bla bla cerebellum, bla bla bla ventricle, bla bla bla mid-line etc. It’s times like that when I’m pleased I work in a neuroscience lab, even if I’m not a neuroscientist by training myself. She established that baby’s brain looked normal and measured the head circumference. All good.

A great view of the eyes (closed), nose and mouth

Then she moved down to the abdomen, and checked the stomach and measured its circumference, which again was normal. A small journey upwards (in baby, so downwards on me – that must be a confusing thing when learning to scan) and she checked the heart, showing its four chambers beating together nicely. Baby was in a good position for viewing the heart apparently, unlike at our 20-week scan when I had to go for a walk to try and shift him/her into place. Not that he/she stayed still you understand – there were plenty of kicks, twists and general fidgeting movements throughout the scan. Poor doctors, I thought, having to learn on such a wriggly baby. Still, if they can do one that active, they can do any!

Next she moved down to the femur (thigh bone) to measure it. At that point the sonographers advised me to look away and they turned the screen around out of my view, in case I happened to catch sight of whether baby is a boy or a girl. After the leg was successfully measured (it took several attempts as baby was moving so much), she moved on to what they were calling the ‘AFI’. It became clear from the fact that they were measuring the amniotic fluid around baby that the ‘AF’ stood for amniotic fluid, and the next day I learned that ‘I’ stood for index.

That was the end of the first doctor’s turn, and the second one took over and did exactly the same thing. By the time she was on her last measurement, after 45 minutes of lying on my back, I was starting to feel a bit lightheaded – this is quite normal in later pregnancy when you lie on your back for long periods, because baby presses down on blood vessels so restricts the blood flow. I mentioned it and they were very good, flipping me over onto my left side straight away, as this is the best position to be in for blood flow when lying down. I soon started to feel better. The next question I was not expecting….. the consultant asked me whether I was feeling well enough to lie on my back for a 3D scan! Was I well enough?! Of course!! It wasn’t like I was about to faint, and I wasn’t going to pass on a free 3D scan!

Looking upwards at perfect little fingers

So he took over, showing the doctors how to change the probe to the 3D one and scan in 3D. It was incredible. He focused on baby’s face, and the detail and definition that we could see were amazing. The pictures on here, although good, don’t show it as well as on screen, where the sepia colouring and movements seemed to give the picture an even more lifelike quality and definition. At first it felt slightly odd and freaky to be seeing my unborn baby in this much detail, but soon I was just filled with an amazing feeling of being in awe of the fact I was seeing this! Baby had one of his/her hands constantly up by the head, and this is what was captured in the pictures that the consultant printed out for me. All five of them in the cubicle agreed that this was one very cute baby. I guess they have to say that though, I mean you wouldn’t tell a pregnant mum that her baby is ugly before it’s even born.

After about 10 minutes of 3D scanning, the session came to an end and I was thanked several times, given my photos to take home, and handed some tissue to wipe the sticky gel off my tummy. What an amazing experience, I thought, and couldn’t wait to go home and show Tom, Andrew and Granny the pictures. I was also looking forward to doing it all again the next day.

A bit shy, looking down to the left, hand in front of face

Scan 2

I don’t think it would have been possible to beat the enjoyment of the first training scan, so I wasn’t bothered that the second one didn’t quite have the same ‘wow’ factor. This time I was in a cubicle with just three people – two midwives who were training to become midwife sonographers, and one midwife sonographer doing the training. I had thought it was doctor training, but it made no difference to me who they were, I just got to see baby again. Interestingly I met a male midwife for the first time; I knew they existed in small numbers, but it was nice to actually meet one in person.

Today’s trainer obviously had a very different approach to teaching compared to the trainer the day before. She was much more hands on, literally, as she was quick to grab their hand on the probe and move it how she wanted them to, whereas the consultant had done much more verbal explaining, with the odd occasion of doing it for them by directing the probe himself. She was also very talkative, and engaged more with me (than the consultant had) as well as with the trainees, who were very quiet and kept their eyes on the screen for most of it. I’m not sure whether they were just concentrating, or trying to avoid interacting with her too much, as she was very enthusiastic and keen to show them everything she knew about what they were doing. It was hilarious, being a kind of fly on the wall (OK, not quite such an inconspicuous one!) witnessing this interaction between a slightly eccentric, but eccentric in a lovely way, trainer and her trainees.

So this is baby's head on the left (the skull bone of the forehead is showing bright white), and the blob at the top right is the arm and hand near the mouth, just as in the 3D photos. In fact if you imagine looking down on this picture from the top, that's what the 3D scan was picking up.

Of course I made the mistake of warning them that I had felt a bit lightheaded towards the end of yesterday’s scan. This provoked a reaction from the trainer of constantly asking me if I was OK and turning me onto my side frequently, and also praising me several times for giving so much of my time by coming twice and repeating how grateful they all were. She said it was good for them to learn to scan a woman on her side, so I shouldn’t worry. I wasn’t worried, it wasn’t that bad, but I let this slip before I’d had chance to experience her personality.

The trainees basically did the same measurements as the ones the day before had done, so by the end I felt like I could have a good shot at measuring if I’d been given the chance (no not really, it looks incredibly difficult to scan!) Again there was lots of wriggling, but the trainer was keen to point out that this was a good experience for them. This time baby was in breech position, which helped to explain all that wriggling the evening before. I think this baby must turn around all the time, and I just hope he/she gets in to the head down position and stays there before it gets too tight on space in there.

There was no 3D scan on offer at the end this time, but the hilarity of the printer breaking down kind of made up for it! I tried to explain that it really didn’t matter if they couldn’t give me pictures today because I’d had such good ones yesterday, but the trainer, as you might have guessed, was not having this as an option. She pressed the print button several times, 11 in fact (that’s how many photos eventually spurted out when it was fixed), and fiddled about trying to get it to work, whilst making lots of noise about this technology failure, complaining that this machine wasn’t as good as the one she normally uses, and generally making a big fuss. She figured out that she could save them onto the hard-disk, and insisted that the administrator would sent them to me. But just in the nick of time, before I was about to be brave and try and leave, a technician arrived and sorted it all out using the reset button. Again I got a flood of thanks, and of course apologies for the hardware failure, and at last was on my way back to the office.

I thought I should include some of the 2D photos too in this post, given the faff of the printer failure - I feel I owe it to the midwife sonographer who was desperate that I had them!

So here we are at the end of week 24….

…and as you can see, it’s been an exciting week of seeing baby. This should be the last time we’ll see baby before he/she is born, unless there are any complications that require more scans. I’ve tried showing Andrew the 3D pictures and explaining that the baby in the picture is inside my tummy (pointing to tummy), but he looks at me as if to say ‘are you crazy Mummy?’ He’s still too young to understand, and we’re hoping that this will be a good thing when baby is born, that he’ll just accept that this is what has happened without being old enough to think about it too much.

Outside the bump - not such an interesting view as inside!

Pregnancy diary: week 20 – scanning for anomalies but not blue-/pink-ness

Believe it or not (I can’t quite believe it really) this week is half-way through this pregnancy already! Where is time flying to?! I suppose the first half is in practice shorter than 20 weeks, because (if baby is conceived naturally) you’re already some weeks pregnant when you’re first aware that you’re pregnant: a test shows up positive or you start feeling sick or noticing other signs. For me this was around 4 or 5 weeks, so I’ve only had about 15 weeks of knowingly being pregnant. Somehow over the next 20 weeks or so I don’t think will fail to know I’m pregnant!

Of course it’s only roughly half-way, because babies don’t generally decide to come into the world on their so called ‘due date’. To be fair, the ‘due date’ is technically an EDD – estimated due date – so a certain amount of discrepancy from this is completely normal. A baby is called ‘full term’ if it is born somewhere between 37 and 42 weeks. Born before 37 weeks a baby is called ‘premature’, and the medical world like mums to be induced, or their labour started artificially, if baby is still showing no signs of coming out by the end of 42 weeks. Theoretically it’s a mum’s choice to be induced or not, but from what I’ve heard, most do choose to be induced because of the potential risks that increase as baby stays longer in the womb. So who knows, I might have already passed the half-way point a week ago, or I might have another week to go. Andrew was born only four days after his EDD; it would be nice if this baby also arrives within a week of the EDD either way, but I know it’s not something I can plan.

Not sure this is much different from last week. I don't feel very big yet, even for half-way through, but I remember from last time that all of a sudden around 30 weeks I suddenly grew and then felt *really* pregnant.

Anyway, apart from doing a little happy dance to celebrate getting to 20 weeks, the highlight of this week has been the ultrasound scan we had on Tuesday. All pregnant mums in this country are offered a routine scan sometime around 20 weeks. You don’t have to have it, but I’ve never met anyone who hasn’t taken the opportunity to see the growing baby inside her. The main point of the scan is to check for structural anomalies in the baby. And we were pleased to know that there were no anomalies visible to the sonographer. She had a very detailed look at everything! It’s quite amazing what you can see these days with ultrasound, such detail.

She started with the head, checking the brain and the facial features including lips and jaw for cleft lip. I said to her jokingly that it was a shame they couldn’t spot tongue-tie before birth with the ultrasound 😉 Then she moved onto the limbs, checking all the bones, and counting fingers and toes. With Andrew there had been a short flash through my head that something wasn’t right when she said ‘four fingers…’ hang on, I thought…. just as she followed it with ‘…and a thumb’ Phew! This time I was prepared for the four fingers comment. All present and correct. After that she moved on to the back, checking the vertebrae in the spine, and the skin on the back. The detail in seeing each vertebra was incredible, especially when baby moved and they all waved in harmony along its length. She scanned in two different perspectives, one at a time: first from the side, so we could see the length of the spine as one picture, then from the bottom to the top, going through each vertebra one by one from baby’s bottom to neck, as a cross-section through the body.

Then came a search through the body for the vital organs, including the stomach (which was black, indicating that baby was ingesting some of the amniotic fluid, as he/she should), the kidneys (which were pretty tricky to spot with the untrained eye, until the sonographer pointed them out), and the bladder (at which point we had to look away in case we glimpsed any signs of whether baby is a girl or a boy – more on this later in the post). Apparently the heart is one of the trickiest things to see, especially if baby is lying face down rather than on their back in the womb. Of course our baby was lying face down, which meant she kept getting shadows from the chest as she tried to get at the heart. After tipping the examination table up so I was almost doing a headstand (well, not quite, but that’s what it felt like – I never knew a scan could turn into a theme park ride!), and getting me to bounce my bum up and down on the table, both in the hope of flipping baby over, she decided to send me out for a walk around, and suggested I drink something and eat something sugary as that sometimes gives baby a boost and makes them move! Good excuse for some chocolate if ever I heard it. I should add that ours really didn’t need any encouragement in the wriggling department – he/she wouldn’t stay still for much of the scan – but the idea was that it might encourage a complete flip onto the back.

Baby Cumming at 20 weeks. If you need a little help in figuring out what things are, here's a description. On the right is the head, with an arm held across the head so the hand with 4 fingers visible is in the top right of the picture, next to the nose, mouth and chin that lie to the left of the hand. The other shape (circle-ish) on the right is a cross section through the abdomen (apparently baby was at a funny angle here, so needs a bit of interpreting!) The white line around the edge is the skin, and the black blob to the bottom-left of centre is the stomach - the fact that it is black is a good thing because it shows baby is taking in some fluid and its stomach is working properly.

It was pretty successful, as baby managed to turn onto his/her side, so we got a better view of the heart. Again the detail was unbelievable: you could see each individual chamber and the valves opening and closing with each heartbeat. This has to be one of the most awesome (as in puts me in awe of God’s creation, not dude language) things I have ever seen. Then the sonographer switched on some kind of colour coding, which I presume, if I remember from Biology A-level, was a depiction of the oxygenated (shown as red) and de-oxygenated (shown as blue) blood, to check where each was flowing. It was all good. Finally, she did a few more measurements, another overall check, and took a picture. It was reassuring to know that everything was alright, and that baby was very active (although I can feel this myself, it’s nice to back it up with visual as well as sensory information).

The position of the placenta was also part of the check. If it is significantly low in the womb, near to or covering where baby needs to get out, this would cause complications during birth, and it might be recommended that you have a c-section. But even if the placenta is low-lying at 20 weeks, often it moves up in the womb as pregnancy progresses, so you would be given another scan around 32 weeks to check this. In our case it looked great, and was nowhere near the opening of the womb. She showed us the currently tiny tube that will be baby’s exit, and it’s hard to believe that it dilates enough to fit a baby’s head through!

The other thing that is possible to find out from this scan is the sex of the baby. This is an interesting point to discuss with other parents and parents-to-be. Some cannot wait to find out the sex, for various reasons, and don’t hesitate to be told at the scan. Others know they definitely don’t want to find out the sex, and like to be very clear with the sonographer when he/she asks if they’d like to know. Others are somewhere in between – perhaps they are very curious, but ultimately would like to have the surprise at the birth. I am definitely in the second category I described: I do not want to know what sex the baby is before the birth, and I was the same with Andrew.

My reasons? To me it makes no difference what sex baby is, as long as it is healthy I really don’t mind whether we get fountains or lakes on the changing mat! I’m most certainly not into the whole pink for girls and blue for boys thing, especially not for newborns – I’d rather see them in simple neutral white/cream/multicoloured etc. clothes. In practice it’s actually very difficult to buy clothes beyond the baby stage that are not pink and flowery or blue with vehicles on. If this baby is a girl, she would be dressed in Andrew’s baby clothes that are mainly neutral, and when older, we have kind offers of hand-me-downs from friends with girls, and she would wear these as well as some of the less overtly boyish clothes (e.g. jeans) that Andrew wore. Of course if it’s a boy, we won’t have any issues in the clothes department as we’re kitted out already. One of the best bits of giving birth to Andrew was that surprise of finding out that he was a boy for ourselves when he was placed straight onto my tummy. To be honest at the time I was just happy to hear that amazing cry and know that he was breathing for himself, but after the feeling of relief that the birth was over and went well, I loved the discovery that he was a boy (I don’t mean I loved the fact that he was a boy – a girl would have given me the same feeling – rather I loved that feeling of discovery at that moment in time). I would not want to give that up this time either.

What about Tom? Does he not get any say in this? Handily, and like many other things in life for him, he is describes his take on this matter as ‘indifference’. On the one hand he’d quite like to find out before birth, out of curiosity, but on the other hand he’d quite like the surprise. With one indifferent vote and one adamantly against vote, I win! But everyone is different, and I completely understand why others do want to find out – it’s a personal choice. In talking to other parents I have generally felt in the minority for not wanting to find out baby’s sex before birth.

So that concludes this first half of our pregnancy journey. I hope you’re enjoying the ride with us, and that you’ll come back for more in the second half. There’s no interval or half-time team talk I’m afraid – we start straight back again next week 😉 If you fancy getting an ice-cream though, make mine an ice lolly, thanks (can’t stand sweet and creamy things at the moment, but something cool and fruity would work).