Monday, June 15, 2015

28 week and 30 week care plan

28 weeks
This was a really hard week where I felt really, really low, and was concerned about my mental state.  Or about as concerned as I could be, given that I didn't care.  I mean, I can recognise when I'm not well and I can tell people that I'm not well.

So the scan was fine and the baby was fine.  The baby measures about the 20th percentile, which is in stark contrast to my bump, which measures the 90th or 100th centile (ish) but I am assured that  all is fine.  the sonographer wasn't going to do a doppler scan, but I said the consultant said I should have one.  So he did one, and the blood flow is right in the middle of the healthy range.

I didn't meet with my consultant, instead it was a senior registrar, but she was the right person for me to see at that time, as she was warm and friendly.  She suggested I take anti depressants either now or after I've given birth, as a preventative measure against post natal depression.  I was at risk of PND even before we lost C, so now I figure i'm doubly at risk.  She recommended fluoxetine (brand name prozac) or Citalopram as safe to take in pregnancy.  She also offered me a referral to the mental health team and psychiatrist but said all they'd do is prescribe me anti depressants and give me a number to call if I felt at crisis point.  My midwife can also refer me to the mental health team.

Once home, I found some info about these drugs:

We changed my scans so I would have them at 30 weeks, 33, weeks and 35 weeks.  As I'm having them at week + 6 days this means I have one 1 week before induction.  I also booked weekly CTGs for those weeks when I'm not having scans.

She said that if the baby is breech or transverse at 35 or 36 weeks they'd give me steroids (2 injections 24 hours apart) and do a c-section just after 37 weeks.  When I go in they'll do a scan and if the baby has turned they'd give me the option for an induction.  If the pessaries for induction don't work (and we'll know if anything is happening within 48 hours)  they'll give me a c-section.  Both options I'm happy with.

I didn't go into work that afternoon.  I was too much of a mess.

Addendum - I ended up back at the hospital for an emergency CTG the following day, because I felt so awful I couldn't tell if the baby was moving properly or not.  It took me a couple of weeks to get back to feeling normal, but obviously my normal is not everyone else's normal, as I'm terrified of the baby dying overnight, so whenever I wake up I got to the toilet, drink a pint of water and lie awake till I feel enough movements to satisfy me.

30 weeks
The baby is fine and growing at the right rate.  This won't be a big baby, I don't think I can grow them big.

I saw the same registrar as before and we discussed post natal anti depressants again.  She got out the big book of drugs and looked up info for Citalopram and Paraoxteine (brand name seroxat).  More stuff seems to be known about paroxetine and it seems to be passed through to the breast milk more readily so I think I'm more keen on taking that.  She said that these drugs are considered so safe the neonatal doctors don't even want to know that the mother is taking them, as they see no side effects in the baby.  This is reassuring and means I can discount the info in the links above.

My notes from the meeting also say that we discussed induction, but I can't remember what we talked about.

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