Week 7: Our Little McNugget

Contents: mention of molar pregnancy, mention of miscarriage

The Friendly Neighborhood Pregnancy Center

A lot of people think of terminating pregnancies when they think about pregnancy centers, but that is simply not true. There are several Planned Parenthood facilities that don't even have the faculties to conduct a medical abortion. Plenty of them are more like our local pregnancy center—offering several options for pregnancy, from the mifepristone and misoprostol medication series to adoption to an extensive network of resources to raise your child should you choose to take that path. They also offer free pregnancy confirmation appointments and ultrasounds. 

Anyway, my boyfriend and I are very aware of our finances. 

The plan for our lives was to graduate college, move in, save up, chip a chunk out of the student loan boulder, and go from there. So, we were not financially prepared to have a baby. The baby we were financially prepared for was a little grey tabby that we got off Facebook for free; his name is Merlin, in case you were wondering.

The local pregnancy center had been a fixture of my route to work for over a year before finding out about the pregnancy, so I had made a mental note of it—ultrasound can be expensive! While I had not been expecting to take advantage of their services so soon, I was delighted to be aware of them. 

I booked an appointment online to confirm the pregnancy and get a letter to start an application for WIC—it's much easier to get established with them prenatally as opposed to postpartum. 

I was lucky that my boyfriend was able to take some time out of his workday to come with me. 

After giving my name, we filled out his and her questionnaires on iPads in the waiting room. My questions involved health background information, how involved Dad was, and a list of topics I could check off to discuss. His had questions about being involved and if he'd like to speak to a male advocate about his options as the father. He was not opposed to speaking to someone, but the advocate was out for the day and never called him back…good thing he wanted to be involved and knew how to do that. 

Once they were ready, they called me back. The first portion of the appointment, though, they left my boyfriend in the waiting room. I gave a urine sample and had a one-on-one with one of the lady applicants. I had the opportunity to discreetly alert staff if I was experiencing abuse while providing the sample and less discreetly when speaking to the advocate. 

I completed another paper-pen survey and had a conversation about my answers. For our specific situation, we were concerned about finances. But I would like to say I was highly impressed with the lengths they went through to ensure my safety. 

I cannot overstate how gracefully and compassionately I was treated. Sure, these things didn't apply to my situation, but it was incredible to see these women in action, looking out for their fellow women. 

Honestly, the most annoying part of the visit was the fact that the building stank. The tech apologized profusely and offered me mint and ginger candies—apparently, someone had left their lunch from the year 1998 in the fridge, and they had just finished clearing it out. Luckily, I did not throw up. 

After all the talking, we finally got to go to the ultrasound room. 

The Big Reveal 

My boyfriend and I hadn't let things be real for us, not quite yet. Sure, the pregnancy was unplanned, but that doesn't mean that it would be easy to find out that my little uterine tenant was nonviable. 

In fact, we had decided to nickname our little collaboration "Peanut" for the time being. We didn't want to get attached to a baby until at least our first viability scan. And it was entirely too early to know anything about Peanut other than if they had a heart. 

Now, here's something they don't show on the medical dramas; the first time ultrasound occurs when the baby is about the size of a modest kidney bean. An abdominal ultrasound is not capable of picking up on something so small, so low in the pelvis. Instead, they use what is called a transvaginal probe to take a look. This probe is roughly the size of a Little League whiffle ball bat and about as pleasant to have inserted into your vagina. 

They use these comically large condoms, and up we go! And if you've never had the pleasure, just know they do use lube. 

For me, it didn't hurt, but it was very uncomfortable. 

Your medical professionals will get quite a bit of information from this appointment, not just viability. They will take measurements to estimate how far along you are and ensure this is consistent with your LMP. If the dates are inconsistent, they may opt to use the data from the ultrasound to calculate your due date, or estimated date of delivery (EDD). 

Getting all of this information involves looking at your kidney bean from all the angles and taking some measurements, so not only are they inserting this probe, but they are waving it around like Cinderella's fairy godmother. 

Again, not painful. But certainly not comfortable. 

Whatever discomfort may be experienced, though, was entirely worth it and more. 

This was the first time that we got to see our Peanut. 

They looked like a chunky McNugget, to be honest with you, but it was our McNugget. And the relief that washed over us at seeing a McNugget with a strong heart brought us to tears. 

There I was, on a medical examination bed with a probe up my vagina, holding hands with my boyfriend and crying at the first sight of our baby. 

This particular pregnancy center's ultrasound had a very cool feature, too. They were able to send us a five-second clip of Peanut's heart, fluttering away. And for weeks, I would get misty-eyed every time I watched this video. 

At this stage, Peanut's heart looked like a little jellyfish, swimming in place inside the McNugget. We could see the little bump in the ceiling of their little sac where they were attached to my uterus. 

Truly, I can say there was nothing like it. Seeing that little bean with a little jellyfish heart just added to the conviction we had that we were going to do this, and we were going to do it together. We may not be where we thought we would be in life by the time kids came along, but we were going to do everything in our power to give this Peanut everything we could. 

Call From the Midwife

As soon as we got home from the ultrasound, I got a call from the midwife. 

My lab work from our visit to LDR had come back. 

The conversation went like this: 

"Hey Mel, how are you feeling?" 

"Good! It's been a fairly non-pukey day." 

"That's great! I'm glad you're feeling better. Your lab work came back, and I'd like to send you for an ultrasound because your hCG levels are really high. What are you doing right now?" 

"Um, nothing. We could go right now, I guess." 

"Great! We don't have anything at our office, so I'm sending you to our sister office. They have an appointment in about an hour. Can you make that?" 

"Yeah, no problem. We don't have any plans." 

"Good. And we'll schedule you here after for some follow-up lab work." 

Now, Dear Reader, you may be asking me, Why didn't you ask any questions? Why didn't she tell you what was going on? 

To that, I would answer a question with a question: do you know how neurotic I am? Clearly, you do not, asking me such questions. 

The ultrasound was clearly something that would address her concerns, and I decided to choose self-love in the form of not scaring myself when I would have the answers by the end of these appointments. 

And when I say we got the call as soon as we got home, we were standing in the doorway with our shoes still on. So, we picked up our bags and got back in the car. We figured that we might try and go early and see if I could get probed early. 

The office is owned by the same company as my prenatal office, but this was a family practice. The waiting room was huge, and people with all sorts of reasons for visiting were there. Joe and I did our best to sit away from anyone who seemed sickly and tried to talk about anything other than the ominous, urgent ultrasound appointment. 

I, like a sane person, sat and ate my snacks (at this point in the pregnancy, I was always carrying snacks and barf bags) and minded my own damn business. My boyfriend, on the other hand, decided to Google what an elevated hCG level could mean. Like an idiot. Like the biggest fucking idiot. 

I made him keep it to himself as I kept eating my Honey Nut Cheerios. I could tell from his reaction that it wasn't good, but I didn't need to know to what extent. 

So there we were, crunching on dry cereal and white-knuckling the waiting room chair. 

Finally, we were called back. 

Second Look

The diagnostic ultrasound had much better resolution and detail than the one that morning. We got to see less McNugget and more baby-shape, distinguishing head and butt from each other. The tech even did a 3D scan, and we could see our lumpy, little Peanut as a whole shape, not just a black-and-white blob. 

It was pretty cool, all things considered. We had so many pictures of Peanut, and it was only our seventh week! 

The tech was also very nice, and she had so many sweet things to say about the baby and explained what she was doing and measuring. 

We asked her if she knew what they were looking for, and she didn't have a clue. A diagnostic ultrasound has a list of things they look at, and she was just the one waving the wand. She assured us that a doctor would interpret the results and get back to us before end of day, though. 

From there, we went home to eat before going to the midwife office for more lab work. 

More Stabbing

By this point, my arms were a mess. Between the Urgent Care visit, the IVs at the hospital, the lab work, and now more lab work, I thought they might send a social worker in to talk to me about my "habits". 

The tech at the midwife's office did a fantastic job, though, getting more blood out of me despite the throwing up and previous bloodletting. Apparently, we were re-checking the hCG levels. 

By this point, the bottle I had kept my nerves in was starting to crack. 

"Will we get to see whoever's on today? She sent us for the ultrasound and then here, but we don't really know why." 

The tech promised us she would try and get someone to talk to us before we left, even though we weren't on the provider schedule. 

The same midwife from the hospital happened to be on, and she came to see us in the lab room. Finally, answers. 

She explained that my hCG levels were incredibly high. According to the lab tech, these levels were insanely high. According to the medical chart software? "Incalculably high." My hCG levels could not be plotted on the graph. The results weren't even results! It said "greater than 225000.0 units. 

Suffice it to say that my hormone levels were stupid high. 

Upon seeing the results, the midwife sent me to get a stat ultrasound to rule out a molar pregnancy. Despite the year of experience I had on the postpartum unit, I had never heard of a molar pregnancy before. I asked her what that meant, and she just looked at me for a second. 

Whatever it was, it had scared the shit out of Joe, so she was trying to explain without inciting fear and panic. 

"Well, you don't have one," she started. 

She explained that, sometimes, the body gets confused. A cancerous tumor, called a mole, can appear in the uterus and cause a positive pregnancy test because the body thinks it's a baby. However, molar pregnancies aren't really pregnancies—there is no baby. One of the signs of one is, you guessed it, stupid high hormone levels. 

Human chorionic gonadotropin, hCG, is a hormone produced in the first trimester of pregnancy. It can be elevated with multiples (twins, triplets), and it is responsible for morning sickness. 

The midwife said that the ultrasound showed no signs of a mole or partial mole. She also said that it was amazing that I was upright, much less smiling, with so much hCG in my system. This was incredibly validating. 

I had never been pregnant before, nor had I been around a lot of pregnant women in my life. I had no metric for what was normal and what wasn't. So, to hear that I was actually, chemically fucked up and handling it like a champ was the best news since I found out I didn't have cancer in my uterus! 

The plan going forward included keeping an eye on my hormone levels, having an ultrasound with the speciality clinic at UVA in a few weeks, and having an anatomy ultrasound early at eighteen weeks.  

It seemed like we would have a very well-documented child.