Maybe I just didn't get the memo about what goes on at doctor visits. I went to my first prenatal check-up prepared to be weighed and instructed to avoid booze and cigarettes. I'd scheduled it on a day when my husband was on shift at the fire station, thinking it was going to be a basic, boring visit. I had no idea there would be an ultrasound - one of the transvaginal sorts, and I wish I had not glimpsed the wand they were going to use before it was put to use. Sometimes, when you're dealing with tools of the OB-GYN, it's just better not to know.
Seeing the teensy tiny life growing - at eight weeks, a blob that looked like nothing so much as a chewed-up piece of bubble gum left in an ash tray - was still pretty amazing, though the wand kept pushing on my bladder and it's a challenge to be full of joy and awe when you're trying not to pee on your OB-GYN. The doctor showed me the heartbeat three times before I figured out that the tiny flicker wasn't just a trick of the fluorescent lights. I think she was more excited that I was - it was hard to believe that the little lump would grow up to be a real live baby, and then a full grown person who can ride a bike and shovel snow and swear and go to college and sneak out of the house when grounded and do all sorts of fabulous things. I tried to search for future person-ness in the picture, but kept on seeing a wad of Bubble Yum.
I brought my man along to the twelve-week check-up, during which they did the first trimester screen (consisting of an ultrasound and a blood test) for Down Syndrome and Trisonomy 18. During the ultrasound, the tech cheered and cooed while the baby jerked around - looking like, said my husband, a guy who's been shocked to get his heart going again. I had the idea that fetuses float around through the amniotic fluid peacefully, like astronauts walking in space, and here mine was flip-flopping like a crack head. On top of that, the baby's face looked like his/her father was Skeletor, with its prominent bones, deep eye sockets, and oversized grimace. After the appointment, we took to calling him/her Skeletor - or Skelly for short. Here's Skelly, waving:
The tech said the flip-flops and skeletal look were normal - add these to the list of things you never hear about until you're pregnant, like episiotomies and round ligament pain and listeriosis lurking in soft cheeses and deli meats. Is there some sort of a secret club where people who've had kids get together and decide what to tell and what not to tell their non-pregnant, non-parenting friends?
At the twelve-week appointment, the doctor told us everything looked great. And then, a few weeks later, I picked up a message from her, saying my test results were in for the first trimester screen, the risk of Down Syndrome was elevated, and I needed to call her back right away. By the time I picked up the message, the doctor's office had closed, so I waited anxiously until the morning.
The risk, I learned, was slightly high for someone my age (29) - 1 in 283. That's a .35% chance of having Down Syndrome. I know, that sounds low, and that's what I kept on telling myself, but it was elevated enough that my doctor referred me to a high-risk pregnancy doctor for a high-powered ultrasound, and perhaps amnio, at sixteen weeks. I should have guessed there was a possibility of getting a result I wouldn't like from the screening, but I had just assumed the results would be normal, that the whole pregnancy would be normal and that I might throw up and feel like a beached whale and get a little emotional and pudgy, but it would all result in a healthy baby. During the first week of the wait, the rational side of me repeated .35% to myself over and over again, while the rest of me tried not to get too weepy in public. Then, for two weeks, I forgot all about the test, until the night before, when I felt even more nauseous than at any other point so far in my pregnancy.
This appointment started with a very nice nurse giving me another ultrasound. This time, Skelly was lying face down near the placenta, looking a bit like my dog does when he wedges his fat shoulders in to a slightly too-small space and can't recall how he got there or how to get out. The nurse pointed out all of the body parts - the dark spot that marked the stomach and the skin fold at the back of the neck, which, with a few mouse clicks, she measured.
A bit later, the doctor came in to the room and told us that, at this point, everything looked good. "At first, I thought the limbs might be measuring a bit short - but then I saw you and thought, with a mom that height, these limbs are just right," he said.
I'm 5'2" on a good day, and he couldn't have been more than four inches taller than me. After making a few more short jokes, he offered amnio and, after brief deliberation - things move so quickly in doctors' offices - we went ahead with it, if only to settle any lingering doubts. It can be hard enough to sleep at night during pregnancy without additional what ifs floating through your head.
While preparing the needle and the tubes for the amniotic fluid, the doctor asked if we'd like to know the gender - if so, they'd need to write that on the test order that went in with the fluid. We had five minutes to make a decision we'd casually debated for weeks. We already knew we wanted most of the baby's stuff, especially the big stuff, to be gender-neutral and that, regardless of gender, we wouldn't create a princess or a truck-themed baby's room. I'm all for a little pink, but the amount of pink and butterflies and flowers that floods out upon the news that someone is having a girl, if directed at me, would make me need a massive dose of Pepto Bismol. For some reason, I feel like I can handle a flood post-birth, but not pre-birth. Another friend told us that she got through the last stages of labor by focusing on finding out her baby's gender. Besides, there aren't enough good surprises in life. So, after quick deliberation, we decided we didn't want to know - and that we could always change our minds and find out at the 20 week ultrasound. The doctor then inserted the long needle in to my belly, which hurt far less than when I got my belly button pierced, as he said it would, and I kept my eye on the screen that showed Skelly while they extracted the fluid.
About a week after the amnio, a nurse called and told me everything was within normal limits - no Down Syndrome, no spina bifida. Now, on to the next set of worries - episiotomies, incontinence after giving birth, emergency C-sections. Yes, I've made it to the labor and post-partum sections of my pregnancy books.
