So, I put in the call to get my prenatal papers faxed over to the OB's office so I could get a second opinion. A few hours later, I received a call from one of the midwives, basically asking what was up. I explained to her all my anxieties - that my water would break again, that Ellie's fetal distress was unrelated to the pPROM (water breaking) and the same could happen to this baby, that we weren't doing anything to prevent another preemie or to monitor for problems. I told her I wasn't confident in the plan laid out by the first midwife, that we should just do biophysical profiles whenever I get nervous and I asked specifically why we weren't planning to do 17P shots, even though they are generally recommended for all moms who have previously had preemies.
The midwife talked to me at length - at least a half hour - and she made me feel much, much better. She basically said that looking through my file, it appeared to her that Ellie's prematurity and fetal distress were all because of an infection in the amniotic fluid. If the infection was in the fluid, that explains why nothing wrong was ever found in the placenta. And between the gross break (no water was left at all), the infection, and just general prematurity, Ellie went into distress. To address the possibility of another infection, I've been put on probiotics. That's the good bacteria you hear about all the time that's in yogurt. According to some thoughts, an overgrowth of bacteria, good or bad, can eat away at the membranes and cause the amniotic sac to rupture. Hopefully the probiotics will keep healthy levels of bacteria; the midwives have had success in the past with this treatment for other pPROM patients. I'm also taking an additional vitamin C pill to promote the growth of strong connective tissue.
To address my fears of fetal distress in this baby, I'll be going in for weekly non-stress tests starting at 30 weeks. I'm assuming it'll be a pain in the butt to figure out what to do with Ellie while I go in for the tests, but I think it'll be well worth it to keep me from freaking out about having another preemie. The midwife also offered to give me a referral to see a maternal fetal medicine specialist (MFM), which I may take her up on, I'm still deciding. She also did some research on the 17P shots and came to the same conclusion I did - none of the current research seems to indicate that 17P will help in cases of pPROM or in births after 34 weeks gestation (Ellie was 33 weeks, 6 days, so close enough). And I'm fine with that - I just wanted to make sure they were thoughtfully considered for my specific case.
It's strange, looking back I really don't consider our NICU stay to have been too bad. Ellie spent most of her time growing and gaining strength, and we missed out on many of the issues that plague preemies. But now that I'm pregnant again, I have this intense anxiety anytime I think of the possibility of having to do it all again. I think it's just maternal instincts making me want to keep this baby safe, but now I absolutely know, without any doubts, that it's largely out of my hands.
So now I stay with the midwives and pray for the best! My next appt is April 4, and I'll have my first 1 hour glucose test!
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