The Second Ultrasound: A Scary Proposition

In Sweden you have one ultrasound, typically around week 18 to 19 (see my previous post about that experience here). We were told that you only have more than one ultrasound if there are potential complications.

Yesterday we received news that our baby did not appear to be growing, although our midwife said that it was possible the baby had just shifted position; thus resulting in the uterus appearing like it wasn’t growing (read that story here). We were scared, I cried, Lisa comforted me, and off we went to see what the hell was going on.

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Quick Background on Uppsala:
Thankfully, we live in a city with a hospital. Also, we live in Sweden–where health care for pregnancy is completely free. So we didn’t need to ask ourselves if it was worth the money to get the check up. We didn’t need to consider the expense of another ultrasound. We could totally focus on our family’s health.

That was more than enough to focus on.

Even though we had time to walk to the hospital (20 minutes), we were too anxious, and called a taxi to drive us there (5 minutes).

The Visit:
Once we arrived and checked-in, there were two main tests that would be performed: 1) check the baby’s heartbeat over a period of time and 2) get an ultrasound.

Lisa was in the bathroom when they called for us. I sauntered over to let them know.

“Hi, she’s currently in the bathroom,” I politely and semi-quietly said. “Oh wait, here she is.”

The midwife popped out of her chair, walked immediately passed me and greeted Lisa.

Checking the Heart Rate:
She then said, “come this way Lisa” and led the way to a private room complete with a bed and a heart rate machine. It had two circular sensors that would be strapped onto Lisa: one to monitor the baby’s heartbeat and the other to monitor the number of contractions. Lisa also had a joystick-like object, where she should press the top button with her thumb whenever she felt the baby move.

Lisa was all strapped in, and I sat on a chair next to her bed.

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“Oh, I forgot to introduce myself,” the midwife said. We shook hands and quickly exchanged names (my name was never spoken again).

I miss my prenatal midwife! I thought.

“How long will the heartbeat be monitored for” I asked. After all, we had just heard the baby’s heartbeat at the prenatal clinic, where they said everything was fine.

“It’s different. It could take 10, 15, 20+ minutes. Just look for a check box to be on the machine, and then you’re done,” the midwife reluctantly replied.

“You said the number of contractions will be counted. Is there a number or range that’s good?”

“Everyone’s different.”

I prodded her more to get more specifics. “So should we expect to see 5?”

“Yes, that’s possible. It’s also possible to have 0. Anything is possible.”

“So we could have 100,” I asked, looking for a limit to the number of contractions.

“No, not 100. That would be too high.”

No more was discussed on this or any other topic, since she decided to leave the room. The language that the midwife used was always non-helpful, even with multiple questions.

Lisa and I continued to talk, hold each other’s hands, and tried to relax. Meanwhile, I sent out texts to different parents letting them know what was happening–I always need a support network.

I buzzed for the midwife to come back after the “check-mark” was on the screen. She then informed us that the doctor would look at the output and then determine if an ultrasound was needed. She failed to ever mention how our output looked. I still have no clue if Lisa had any or several contractions while the baby’s heartbeat was monitored.

Thoughts on the Support the Midwife (Didn’t) Give:
It was clear that the midwife made no decisions and could provide few answers, as she placed the results on the doctor the way a guy places his results on his wife–“aw guys, I want to come play poker tonight, but I’ll have to check with my wife first.”

There was clearly no accountability to be had via the midwife. She was there to perform the tasks instructed and to not provide us with advice or support or results.

She could however explain what different machines do or what she’s currently doing–although these responses often left more questions than answers.

Nevertheless, we figured the baby’s heartbeat was good, since we had just had that test completed, and we knew how to interpret the results (this time, the baby’s heartbeat was often around 140-150 compared to the slower 130 heartbeat 30 minutes earlier).

The Second Ultrasound:
We were then taken to the ultrasound room.

“Lisa, please come this way,” the midwife said walking us down the hallway.

“I’m not going to measure the baby,” the midwife said after laying on a thick layer of jelly on Lisa’s belly. “Are you ready Lisa,” she asked.

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She then studied the baby, mainly measuring the baby’s head, stomach, and femur. She was silent, clearly focused on her work. This ultrasound was a lot different than the first. The first time we felt a great joy in seeing our baby on the screen. This time, we felt overly anxious, concerned, and in constant wonder of what was being found as the midwife measured these areas.

Brief side note: The stomach was measured twice, from NW to SE and NE to SW, making an X pattern on the screen.

“Did you also check the umbilical cord?” Lisa asked.

The midwife then checked the flow (of blood or nutrients???–this was never explained, but the answer was simple–after hearing a few beeps and seeing wave-like formations show up on the screen, the midwife announced–“looks good.”

The midwife seemed to remeasure the head, stomach, and femur two or three times, and then called in a second midwife to assess her assessment (although leading questions were asked).

“I measured from here to here and I got a normal number. Do you see that?” she said to the second midwife.

We were then abruptly told that everything was normal. No pomp, no circumstance. It was just black-and-white with no explanation.

I prodded.

“How do you know?”

The midwife then when into a litany of how numbers are calculated based off of the mean size for a baby in the week you’re in (e.g. week 36) compared to the size our baby is.

After the ultrasound, we found out that our baby was -6 on their head size and -3 + -3 on their tummy = -12 overall. Of course these numbers meant nothing to me, so I inquired further.

I can’t remember how long the femur was except that whatever the average was for a 36 week baby, ours was one (cm, mm???) longer.

Turns out that there is a scale for the average head, stomach, and femur (for some reason the femur length isn’t calculated, but is still measured. This was never fully explained to me).

Great, the one part that’s above average isn’t calculated into the proper growth of our baby’s size, I thought.

Then they take how long our baby’s head and stomach are, and those numbers are subtracted from the average baby at our week.

You’re considered “normal” or “healthy” if you’re between +22 to -22.

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Meeting the Doctor
We then met the doctor. She had only one agenda–to reassure us in as many different ways as she could that there was no problem. Again, without going into as many (apparently needless) medical details as possible.

“Do you know why you’re here?” she asked as an opening statement.

“To check on the growth or lack of growth of our baby,” Lisa quickly responded.

“Yes, that’s right. Well, this is as perfect as it gets. You’re great. You fall within the normal range. Everything is fine. You have nothing to worry about,” she said.

“You can go home and enjoy your New Years,” she continued.

Again–I had lots of questions, but clearly could see that those were not welcomed. In fact, at one point I even called her out saying “Yes, I get the point that you clearly have one job–to make us feel calm and safe, but…” and then I continued asking several questions of things to look out for or how to prepare ourselves should this arise again, and what to do at our next prenatal meeting.

Conclusion: The doctor could only guess like our original prenatal midwife–that the baby had just shifted position in the body, making the uterus appear as though it’s not growing.

I told her I was quite interested in what was happening with our baby, which is why I had so many questions.

Rather than finding it beneficial to have involved parents seeking answers from a professional, her response to me stating my interests was simple, but dumbfounding.

“Google it,” she said.

“Really? We come to the hospital seeking answers from a professional and your response it ‘Google it’?”

She then argued why Googling was a good method, but that people can’t interpret the results well.

Well no shit! That’s why we’re talking with you right now. We want to be informed parents and understand the potential situation our baby may or may not be going through. Plus it just doesn’t hurt to know more, in case this same thing happens again in the future with another child, I thought.

We left the hospital feeling glad that nothing was wrong with the baby (as far as they could tell). The first baby scare was over. For now.

But I also left the hospital with a pain in my stomach, knowing that I could have a midwife as inattentive, unsupportive, and unwelcoming as her when we give birth.

Fingers crossed that we have one like our prenatal midwife!

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Tried to go into town to enjoy the Christmas lights.

PS–Interesting side-note, the midwife said it wasn’t a problem to take pictures during the ultrasound, despite the first ultrasound midwife saying that we weren’t allowed to take pictures. Of course, no explanation was given on why it could or could not be ok to take pictures during the ultrasound.

PPS–This has so far been our fifth midwife, and we haven’t even given birth! Talk about a lack of continuity of care, as well as trying to develop trustful, stable relationships! Not ideal, Sweden!

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