3 words...round ligament pain. Oh my.

This is probably my biggest complaint over the past couple of weeks. And my goodness, it is uncomfortable! Round ligament pain happen as the uterus expands in pregnancy. There are ligaments (special muscles) that hold the uterus in place in the abdomen. During pregnancy, the uterus expands and the fetus grows and consequently these ligaments have to stretch to accommodate the larger size of the uterus. Just like when you stretch any other muscle in ways it is not used to, pain can result. Even though I've experienced it before (with my previous pregnancy), it's still a shock when it happens. Sometimes it occurs when I get up from a sitting position or when I roll over at night. It can happen at other times as well, but those are fairly common. The pain is a shock that takes my breath away until it eases, just like any kind of muscle cramp would.

I also had a slight illness scare during Week 17 that called attention to how scary it can sometimes be during pregnancy. Right at the start of Week 17, we found out that a case of Fifths Disease had been confirmed in our other child's room at daycare. Fifth's is an annoying, but generally benign childhood disease. It usually involves a rash and flu-like symptoms. By the time they're out of childhood, most people have had this disease and developed immunity to it. Further, it's usually no big deal when a child (or adult) ends up with it. However, that's not necessarily the case when you're pregnant. For pregnant women who are not immune, it is possible to contract the disease and have it impact the pregnancy. In women who contract it before 20 weeks, about 5% will end up losing the pregnancy. Because a child who was in contact with my child had this disease, it's possible that I was exposed to it as well. Because Fifths was not being diagnosed as such (and there were not tests for it yet) when I was a child, I actually had no idea whether I'd had it in the past (and thus would likely have immunity) or not.

I called my OB's office as soon as we found out, explained the situation, and asked for their advice. While it is likely that I am immune, they wanted me to have a simple blood test anyway to determine whether I'd been exposed or was already immune. It can take more than 10 days to get the results of the test, so I'm actually still waiting on the results. However, since nobody in my house has come down with it, I'm hoping we're all immune and this will not be an issue for us.

This really made me think though about how scary it can be when you're ill and pregnant at the same time. Illness is not fun at the best of times, but during pregnancy everything seems much worse. Certain illnesses that are "no big deal" most of the time can be dangerous to a pregnant woman or a fetus. Not to mention the fact that if you do become ill, there are many medications you cannot take. Medications during pregnancy are discouraged, period, unless there is a clearly established need for them. There are some things that studies have shown to be safe, but there is also a hefty list of those with more significant risks. Even a regular cold can see so much worse when pregnant if you're avoiding cold medicines.

I'm sorry my blog is a bit behind here! Life was busy last week and somehow I just never managed to sit down for more than 2 minutes to be able to talk about what was going on with my pregnancy.

On the positive side, during the last week to week & a half, I've been feeling better. This is likely related to coming to the end of the first trimester. My afternoon/evening nausea is starting to abate, thank goodness. I was getting very tired of being almost unable to eat after lunchtime. I've also noticed that, especially within the last week, my anxiety has decreased as well. This is a distinct relief.

While I know it seems superficial, my biggest complaint right now is about clothing. My pants still fit (barely) around my slightly thickening waist. I don't look pregnant, rather just as if I've put on a few pounds around the middle. (My weight is actually still down overall though, so I must have been losing in one area and gaining in my abdomen.) If I button my regular jeans it is uncomfortable to sit down. When I can, I wear the maternity clothes that I saved from my last pregnancy. I'm not big enough to wear the pants with the full belly panel, but they make some very comfy bottoms with low slung, elastic waist bands. Unfortunately, I only have a few pair of those pants and (to my great frustration) my favorite local place to buy pants doesn't have my size nor does the website for that particular retailer.

On the up side, the "hairband trick" still works with my regular pants in a pinch. In case you've not heard of this, it is where you wrap a hair elastic around the button of your pants, thread it through the button hole, and wrap it back around the button again. It'll secure your pants so that they don't go anywhere while gaining you an extra inch or two in the waist. It doesn't look cool and necessitates a long shirt to cover the waistband, but it works to keep pants from falling off.

My uterus is around the size of a grapefruit this week. I'll admit, I find this rather amusing. When you look at sexual anatomy diagrams (which are generally shown non-pregnant anyway), the uterus usually looks pretty large. In reality, it's about 3 inches and looks a bit like a pear. By 10 weeks, my uterus is now more the size of a grapefruit. In the grand scheme of things, this is still pretty small. This week, my embryo became a fetus. It is now just over an inch in length.

I also had my most recent checkup with my OB this week. Early in pregnancy, women are generally seen every 4 weeks (if you have a high risk pregnancy, it may be more often). My blood pressure and urinalysis looked good. One of the things they gave me is a special card that has my pregnancy information on it. It includes my EDD (estimated due date), blood type, Rh factor, and other information from my OB blood panel. I'm supposed to carry the card with me. If I were to be hospitalized, it would give other health care providers to have the basic information they needed to treat me & who to contact for my records.

I also was able to hear the heartbeat this week. They can usually first detect the heartbeat on a special handheld monitor sometime between 10-12 weeks. The medical assistant had to search, but it was there. My little peanut was bouncing along at 170 bpm (beats per minute), which is in the range it should be at that point.

They were a little bit worried because I had lost 4 lbs since my last appointment (4 weeks prior). This is almost certainly related to all of the nausea I've been experiencing. It is generally preferable not to lose weight during pregnancy. Because I've only lost a small amount so far, my OB/GYN is not too worried yet. He said that I need to try to make sure I'm eating properly, as much as I am able. I've been treating the nausea using various natural methods (ginger teas, sour candies, B6 supplements (taken according to my care provider's instructions & dosages)). I also have some prescription anti-nausea medication that I can take when it gets really bad. Usually they want you to try to avoid medications when pregnant (especially during the first trimester), but there are times where the rewards outweigh the risks of carefully chosen medications that have been shown to be safe. I try to avoid needing the medication, but if the nausea is so strong that I can't focus or keep down food, it becomes necessary.

Overall though, I'd say I feel pretty good. I am still tired and nauseated much of the time. I'm also still anxious. We discussed ways to manage my anxiety and my OB ordered blood work to check my thyroid. If it is still an issue at my next appointment, we'll look into it further. I've been using my management techniques with some success this week but it has been a hard week. A friend-of-a-friend who is also a young mom passed away unexpectedly this week. Another online friend had her baby this week and after delivery they discovered the baby has some health problems and will likely be having surgery in the next few days.

Last weekend, I dug out my maternity pants from my last pregnancy and laundered a few pair. In spite of losing 4 lbs, some of my regular pants are becoming increasingly uncomfortable around the waist. I have a couple pair of regular jeans that are alright, but it would be nice to have more options. So I got out 2 pair of corduroy pants and a pair of jeans that I had saved. They have elastic waistbands and sit low. (If you're familiar with maternity wear, I'm not wearing the kind with the full belly panel yet. I'm nowhere near that.) They are much more comfortable that squeezing into my other pants. You still would not know I was pregnant just by looking.

If you have questions, please feel free to post them as comments to the blog. I'll answer as I am able/comfortable doing so.

I'm pregnant.

It looks like such a small sentence, but in reality it is not small at all. Pregnancy is a big deal. It changes lives, both during a pregnancy and afterward. Bodies change, relationships change, lives change. It can be exciting and terrifying all at the same time. So I start this with a small statement with big implications.

At Scarleteen, we see many questions about pregnancy. Often they are about a specific pregnancy risk or whether someone is pregnant or not. Sometimes it is about the choices that accompany a pregnancy. Sometimes there are questions about the things that happen during pregnancy.

I'd like to share with you, in this blog, about my pregnancy. It is not my intention to suggest that this is what every pregnancy is like for every woman. I am not arguing that my choices are the "only" or "best" way. I want to talk about my experience and my perspective. I want to share the good parts and the bad parts.

To that end, I feel like it is important to tell you who I am. I’m 31 and this is my second pregnancy. I have a preschool aged child already. I am legally married to my partner. I have health insurance through my partner and my current OB/GYN is the doctor who delivered my first child via caesarian section (c-section). I have a BS and an MA and I currently work full-time. I would consider myself to be reasonably healthy. I do not share these things about myself to indicate that this is the way it “should” be done, but rather because my physical and social context make a difference in my pregnancy experience. Every woman is different and every pregnancy is different.

After much discussion, thought, and preparation, my partner & I had decided that we wanted to try to add another child to our family. It was not a decision we made quickly or lightly. Adding to a family is a big deal. With the current state of the world and in an economy where no job is guaranteed, adding another person to be fed and cared for can be a scary thought. While I do work full-time, my partner is the primary income in our household. What would happen if one of us lost a job? What if something happened to me during pregnancy or delivery? Childcare is expensive, could we manage that and the other expenses? Did we have room in our current home or would we need to move? What did we have to offer a child?

After many months of discussion, we decided we wanted to try to conceive. With our previous child, I used fertility awareness (FAM) to chart my basal temperature (BBT) and cervical mucus (CM) to help determine when ovulation was occurring (and thus to increase our chances of success). I believe we tried for about 3 months before becoming pregnant the first time. This time around, I was not able to chart as regularly as I had before. In order to get the most accurate BBTs, it’s important to chart after at least 3 hours of uninterrupted sleep and to take the temperature at approximately the same time each morning. With a preschooler who is in a “wake up ALL THE TIME” phase, this was extremely difficult. In fact, for them most part I was unable to take reliable temperatures so I relied mainly on observing my CM to even guess at ovulation (so I was likely not as accurate this time). We tried for 5 months this time before conceiving.

In spite of the fact that we were trying, I was surprised. With my last pregnancy, I knew when I had ovulated and I tested positive on a home pregnancy test at around 8 days past ovulation (which is very early). I tested at what I believed was 12 days past ovulation this time and it was negative, so I fully believed that we had not conceived during that cycle. However, just after Christmas I tested again on a whim and this time it was positive. I was surprised. I was shocked. At first, I stared at the test and couldn’t figure out what to do. “Oh my,” I thought, “What have we done? What am I going to do?” I know that probably sounds strange, given that I was deliberately trying to become pregnant. But pregnancy is a big deal. For me, I think it’s always one thing when it is theoretical and another when it is ‘real life.’ So my reaction to both pregnancies that I’ve had has been happy tempered with some shock.

Once I processed this new information and shared it with my partner, I began the process of getting used to this new state of being for me. (Incidentally, my partner was extremely happy and excited about the revelation.) It took me a few days to really wrap my head around it. For a week, it was just about all I could think about. Every other thought started with, “I’m pregnant.” Slowly, it started to become a more normal thought and I settled into being happy about it.

My positive pregnancy test was at about the time I would have missed my period. I tend to be irregular anyway, so I had not even realized I was late when I tested. I wasn’t experiencing any symptoms, I just tested on a whim. Based on my last menstrual period (LMP), I was 4 weeks pregnant when I tested positive. Health care providers generally date pregnancies based on LMP. Even though the pregnancy itself was only 2 weeks old (based on when I had likely ovulated), I would have been considered to be 4 weeks pregnant. I had already been taking prenatal vitamins, so I continued with that.

I called my OB/GYN’s office and made an appointment to come in for a first prenatal appointment at approximately 6 weeks pregnant. When I arrived for my appointment, I was given another pregnancy test and they also checked my urine to be sure I didn’t have a UTI (standard procedure in this office). After confirming the pregnancy and measuring my height, weight, and blood pressure, I met with one of the office midwives to discuss my care. She asked about my LMP and figured out my estimated due date (EDD), which would be in late August. We also talked about my medical history and my partner’s medical history. Since I’ve been with this office for several years and delivered my first child with them, my medical record is already established there. However, it was very important to go through and update the record since my last appointment there. After that, we discussed my wishes for this pregnancy and went through the usual list of dos & don’ts during pregnancy. In addition to taking prenatal vitamins, we talked about the things I needed to do to care for my health during pregnancy. There are many medications that pregnant women should not take. There are also some foods and activities that should be avoided. Although I had heard these lists before, it was a good reminder since it has been several years since my last pregnancy. The midwife also asked me about any concerns that I had. At 6 weeks, I was not experiencing much in the way of side effects, except for some cramping. I did not have cramping during my last pregnancy, so I wanted to ask about it. She assured me that this was normal and was more common with subsequent pregnancies. As long as I was not experiencing extreme pain or bleeding, it was nothing to worry about. Before leaving the office, I had to read and sign several forms about keeping appointments, the risks of smoking during pregnancy, and prenatal testing that was offered by the office. I also scheduled my next appointment for 4 weeks afterward. They also gave me an order to have some bloodwork done.

Right now, I am about 8 weeks pregnant. For the most part, I don’t feel that much different than I did before I was pregnant. The embryo is only about the size of a kidney bean, so in terms of feeling changes it is still extremely early. Of the traditional “symptoms” you hear about, the only thing I’m experiencing right now is some nausea, increased urination, fatigue and some breast tenderness. I don’t have “morning sickness” in the traditional sense. Instead, I wake up feeling fine, but start feeling nauseated sometime around 3pm. It gets worse as afternoon and evening progresses. For the most part, I don’t vomit, but the nausea can be really distracting at times. (This is not surprising for me since I had the same kind of ‘all day nausea’ with my previous pregnancy as well.) In terms of the increased urination, this is likely related to my increased water intake and growing blood volume. During pregnancy, a woman’s body produces extra blood. This means that there is more fluid for my kidneys to filter and thus more peeing. At this point, it means I’m urinating a couple of extra times each day. I do find that I am more tired during the afternoon, but so far I’m actually less tired than I was with my first pregnancy. I don’t look pregnant. My clothes still fit the way they did before. I’m not consuming massive amounts of pickles and ice cream. If I haven’t told you that I am pregnant, there is no way that someone would know.