Yesterday Ryan and I had our first appointment with a maternal fetal medicine specialist. The purpose of the visit was to go over all findings and get a specialist's input on what happened to Evangeline, since my regular ob didn't really have answers besides the umbilical cord. We were also there to talk about what to expect in a future pregnancy.
First we met with the genetic counselor who expressed her condolences, asked us about our medical history as well as our families, then she asked me to describe my pregnancy with Evangeline and talk about her birth. I thought I would cry, but it was actually easy to talk to her. She asked for both of our girls' names and specifics on each of them. She then asked if we had any questions and said the doctor would be in shortly.
Our doctor came in and introduced himself to each of us. He expressed his condolences to each of us and shared that he and his wife lost a child at 20 weeks. He looked at me and said "I may not know everything that you're experiencing..." then looked at Ryan and said "But Ryan, I can understand a lot of the feelings you may be having..." It's touched my heart because I often feel like Dads are sometimes forgotten.
He right away had an explanation as to what happened to Evangeline... He does not attribute her death to the umbilical cord. He said after looking at the pathology reports, and the size of the placenta and Evangeline he is very confident on her cause of death... Incomplete implantation of the embryo in my uterus... The final step of implantation involves the placenta, and if it does not fully implant properly it can lead to a weak placenta. This all occurs within the first 5 days of conception. A weakened placenta from this will cause the placenta to deteriorate overtime and lead to intrauterine growth restriction (IUGR) of the baby. This is what happened to our little girl... Her weakened placenta could no longer provide her with enough nutrition, it restricted her growth and ultimately caused her death. He explained that this was in no way my fault. There was absolutely nothing that I could have done to affect the implantation. A 20 week ultrasound would not show any difference compared to a healthy placenta. His trained eye can catch the changes at about 23-26 weeks on ultrasound. I had a risk free pregnancy, nothing out of the ordinary.... So I only ever had a 20 week ultrasound... They would not have seen anything suspicious at that point.
Doctor then went on to say that although I do have a slightly increased risk of IUGR in the future because of a history of it, he is confident that it was just a lightning strike occurrence since Mariah was a good size. In the future I will see my ob for regular visits, and then I will see mfm doctor as well... Basically double the doctor visits. I will get monthly ultrasounds and loads of nonstress tests. He will be following the growth of the placenta and baby very closely. We can do an amniocentesis at 36 weeks and possibly deliver before 37 weeks if it shows lungs are developed. This is important to me since Evangeline was born at 37 weeks... I will be incredibly anxious at that point in a pregnancy. He also said that if he would get any inclination from an US or NST that something is very wrong he would not hesitate to take the baby even earlier than that if he cannot guarantee the baby would still be alive the next day... A baby in the nicu at least has a chance, when a baby struggling in the womb may not.
At the end I asked him what I should do differently in the future... He looked down at this notes and said "Well Robyn, looks like you didn't do cocaine or drink alcohol while pregnant so I think you're good to go. This wasn't because of something you did or didn't do. You did nothing wrong." This provided so much relief to me.
I have found such a renewed sense of hope. I am so thankful to have this doctor as a part of our team. I fully trust him to care for me and a future baby. He not only addressed both of us by name the entire time, he also addressed both of our daughters by name while talking about each pregnancy. Recognizing Evangeline as our daughter and not just "the baby" or "the fetus" really touched my heart, because that is exactly who she is to us... Evangeline, our daughter. And although I wish he didn't have his own experience of loss, it comforts me to have a doctor who understands this pain, because I can just feel that he will do everything in his power to help us bring home a rainbow baby after this storm.