29 weeks + 1 day, 12 weeks + 3 days post rupture, day 40 at my parent's place.
As a mentioned in my Thursday post we are starting to get to a 'decision making' point in this pregnancy. Dr. Eeyore (who I will now start referring to again as Dr. S. as he is no longer such a downer) actually left the room at one point on Thursday to discuss my case with other OBs in his practice. His question for them was "when should I deliver this patient?"
Their answers were the standard "let her go to 34 or 36 weeks if she's stable...and by the way why if she's a pPROM isn't she in hospital?"
The answers these other OBs gave made me kind of nervous. They were using the textbook 'standard of care' model to answer his questions, but as we know, I'm not the standard.
At all. Ever.
And it wouldn't matter so much what those other OBs think as long as Dr. Eeyore (whoops, Dr. S.) and Brian and I are all on the same page. If he thinks it's best to deliver at 32 weeks and the NICU team agrees, I'm all for it. I recognize that every day I stay pregnant I'm helping Acorn to avoid 'preemie' problems, but I also recognize that each day is another day I could get infected which would drop Acorn's chances of survival significantly. So maybe it would be better if I hit 32 weeks and baby still looks good, we call it a day and say "ok, Acorn you're coming out!" I especially liked that Dr. S. is leaning towards 32 weeks because he doesn't want to push our luck. He's conscious of our prior loss and this past Thursday was the first time he ever referred to 'what we've been through'. He wants us to have the best shot possible at a healthy baby, and that means the world to us.
So Brian and I figured we take it a week at a time. Each time we see Dr. S. we'll make a decision regarding Acorn: take him this week or leave him?
Then we found out Dr. S. GOES ON VACATION FOR FIRST THREE WEEKS OF JULY!!!! (Weeks 31 through 34 of my pregnancy, assuming I get that far).
Now I know, everyone deserves a vacation, and July and August are big vacation times here in Canada so I shouldn't really be surprised. Plus, we still have two more appointments with Dr. S. (June 23 and 30th) where I hope we can devise a plan...but after that, some other OB will be 'managing' my case. Now it won't be so bad if it's say, Dr. K. I trust him and he knows about our 'case', but it could be some doctor we've never met before! This doctor might not be as willing to do a C-section on a woman whose 'doing well' at 32 weeks and might want to 'push it'. That might be a good call, or it might not be. But I would hate to leave that decision with a doctor who we might have just met.
I feel like if Dr. S. goes away and I'm still pregnant, Brian and I might have to be more forceful in terms of advocating for ourselves with a new doctor on board, and might be more responsible for decision making. Taking Acorn out at 32 weeks (or 30, or 31?) might be a good call. But what if Acorn suffers from more preemie problems due to us 'rushing' in, like NEC or IVHs or a PDA or even less serious ones like GERD. And what if his or her lungs are 'worse off' then they would have been at 34 weeks? But what if we delay hoping for a bigger, stronger, more mature preemie, but then infection sets in. An infected baby at any age is bad news.
And don't get me started on the lungs...the state of Acorn's lungs keeps me awake at night.
Who knew this 'parenting' thing would be so HARD? Of course, the up side of having to make the decision of when to 'start' our premature baby's life, is that it will hopefully make any other normal parenting decision we have to make seem easy by comparison. When should we start solids? Who should babysit our child? What school should Acorn attend? Can Acorn walk to school alone at age 12? Should we allow Acorn to go on an overnight camping trip with friends at 15? Should we be upset if Acorn gets a tattoo at 17?
Those will be cake by comparison. Now if we could only be assured we'd get there.
Have you ever had to make any life or death decisions for your child, either the living or the dead? Did you feel afterwards that you made the right call? Why or why not?