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Hedra's Pregnancy Journal

Nineteen Weeks, 5 Days ~ July 8, 2004
   ~ Balance and Risk

I lost my balance yesterday. In the literal sense. That is, I fell down. Tumbled face-first onto the driveway. OW.

It hurt a lot - labor wasn't as bad as that. I actually cried from the pain when I was rinsing the scrapes on my hands. I never did THAT in labor. But while I landed badly for my hands and knees, I landed pretty well for baby. All the shock was absorbed by my wrists and elbows on the top half of my frame, and by my knees, square on, for my lower body. I also have some training at falling from my old ice-skating classes, so I automatically rolled to the side on impact, since I couldn't exactly slide on the asphalt driveway. (I ended up sitting in a huge puddle, but at that moment, I just did not care!) That tumbling kind of impact helps reduce shock injury to the body (and therefore to baby, too) - reduces the risk of the placenta tearing or abrupting (pulling away from the uterus - a high risk emergency for both baby and mom). I still hit hard, so not a full removal of that risk, but a better fall than tummy down or square on the behind. I managed to scrape up my hands and one knee pretty badly.

With the instructions from one of the midwives, I monitored the baby 'the old fashioned way' for four hours (making sure my uterus wasn't hardening - a sign of abruption, I wasn't spotting, I wasn't going into preterm labor, and baby was moving as normal). I had three Braxton-Hicks contractions in three hours, but that's within the normal limit. The baby moved around a bit, and my uterus stayed nice and squashy to my gentle palm-down checks. Today, the baby seems perfectly happy, as well. Kept me awake rumbling around in there all night, and is turning and poking and pushing around right now. (It seems to like wandering around at night, when all is quiet. Driving seems to make it snooze.)

My unexpected tumble, plus going in for my level-2 ultrasound tomorrow, has me thinking about risks.

There sure are a lot of them!

At the same time, we've lived with most of these risks for as long as women have been growing babies.

And at the same time, many babies (and moms) in the past didn't make it or were injured because a risk was not known or understood.

And further at the same time, some of the methods used to manage those risks include risks of their own.

There's a balance there. Medicine has certainly saved a lot of lives. It also needs to be used with awareness. Thoughtful, evidence-based approaches help reduce risks without creating worse ones. So does individual attention to detail, managing to the mom and baby based on their own data, not to a generalized standard. I like being more than a point in a statistical range. After all, statistics don't apply to individuals, only to groups. I'm one point. I could be ANYWHERE in that range.

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Managing risks in all their variety takes a fine balance. I'm impressed when doctors and midwives do it well.

Getting my mind around the risks and yet not letting them run away with me is also a matter of careful balance. I think it helps that I see midwives, and they are more 'normalcy' oriented than 'danger' oriented. Not that they're unaware of the risks. They certainly responded with caution to my fall, though they allow some leeway for personal judgment from my end as well. Heck, with Gabe, I didn't even know I was supposed to tell anyone if I fell. This time, I at least knew to check in. Placental abruption, while not a hugely common response to a fall, is still a risk.

There's that word again. Risk.

Merriam-Webster defines it as "Possibility of loss or injury: (see also, Peril)"

Peril. now there's a word I didn't want to associate with pregnancy!

I certainly have a lot of risks. I'm of advanced maternal age. Right off the bat, I'm a risk heading all by myself. Risk of chromosome abnormality. Risk of unexplained stillbirth. Higher risk of multiple pregnancy (with the attendant risks of that). Higher risk of c-section. Higher risk of premature birth or low birth weight. Higher risk of gestational diabetes. Higher risk of pre-eclampsia. Heck, higher risk of having a pre-existing condition that might complicate pregnancy.

All that from just my age.

And yet. Then there's me, personally. I've got a lower risk of c-section, due to having had 2 previous vaginal births. Lower risk of premature birth because both were full term. Lower risk of low birth weight because both my previous children were good sized (that one makes me chuckle - Brendan was 9 lbs 6 oz.).

My risk of gestational diabetes is balanced. I've got a higher risk due to a high one-hour test the last time, but lower because I weigh less this time and have been eating a low Glycemic Index diet for much of the pregnancy (okay, that one is my own opinion, it hasn't been actively studied). My risk of pre-eclampsia is lower because it isn't my first baby. My risk of chromosome abnormality is higher by age, and my risk of unexplained stillbirth is unknown.

So, not all that bad, for an elderly mommy. And more accurate, because it is based on ME.

Generalized environmental and health risks are EVERYWHERE. But my own personal environmental and life risks are pretty small. My kids are healthy, I've got good iron stores, I've got many social and family resources as well as medical resources. I wash my fruits and veggies, avoid volatile organic compounds (like in paint and solvents), stopped eating sushi and lunch meat when I got pregnant, and take my folate.

Now, if I can just manage to keep BOTH feet underneath me when I walk. okay, even ONE would help! Then, I should be fine.

And tomorrow, we'll find out if I'm having twins, as Gabe thinks, or not, as I think.

If Gabe is right, I think that will throw me right off balance... but that is a risk I'll live with.

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