Jeff and I tend to be minimalists when it comes to the expensive aspects of prenatal care like ultrasounds.  “Only the ones absolutely required and necessary” has been our typical approach.  So to have had FIVE ultrasounds for Joel has seemed excessive, yet we are attempting to be as compliant and cooperative as possible, appreciating that our doctors have a strong interest in monitoring how Joel’s health affects mine and also realizing that the knowledge they gain through scanning will help them feel confident about his birth plan.  This time, it’s not just about us or about Joel but truly about cooperating with the team of people we trust to guide us through a relatively rare and uniquely individual situation.

Jeff and I went for ultrasound five on the last day of 2015, and it was brief and routine by comparison to U/S four.  It was also our last scheduled U/S, unless there should be some obvious change necessitating another one.  Otherwise, we will have one last brief scan just prior to birth to confirm Joel’s position and take final measurements to assist in last-minute birthing decisions.

There were a few new observations:  Joel’s heart has a VSD (Ventricular Septal Defect), in addition to the ASD (Atrial Septal Defect), which had been noted previously.  The technician also noticed that he most likely has a diaphragmatic hernia, which is allowing his lower organs to migrate into the chest cavity.  That conversation went something like this:

“And here’s his lung…. (long pause)…. actually, I’m wondering if that’s his liver.  It looks like he might have a diaphragmatic hernia, and that might be part of his liver.  Did they mention a hernia to you during the last U/S?”

“No, but at this point, nothing will surprise us.”

“I’ll need to get Dr. B to come and confirm that.”

This tech was among the best we’ve had yet.  I constantly marvel at how many wonderful, amazing people there are in the medical profession.  Sure, we’ve met a handful of distinctly non-favorites, but the phenomenal ones far outnumber the others and have blessed us tremendously!

Dr. B did confirm the hernia.  Neither this nor the VSD make any practical difference in the anticipated outcome or delivery considerations for Joel; they are just new tidbits of information to add to the overall picture of his condition.

In the “good news” category, Joel is now head-down and weighing in at an impressive 5 lb. 15 oz.!  Dr. B believes that he will be able to be delivered vaginally if he remains in this position, and that he will not have to undergo a reduction of the fluid in his bladder to allow for birth.  His head circumference (currently 8-9 cm) is proportionate to his abdominal circumference, allowing him to fit through the birth canal.  Previously, Dr. B had suggested that if his abdomen was too large or too compromised for a successful birth, they would consider using a procedure similar to amniocentesis to draw the fluid out of his bladder just prior to delivery.  As of now, that is not the case, which is truly good news for both of us.

We again spent time talking about our priorities and expectations for Joel’s birth and for comfort care for him afterwards, when/how the children will meet him, etc.  We left this U/S and consultation feeling quite hopeful about the possibility of avoiding a C-section.   We also feel confident that everyone is on the same page and in full agreement with Joel’s birth plan and very thankful that Dr. B will be the ultimate decision-maker for everything related to his arrival.

We’re excited to see God answering some of our prayers related to Joel’s birth and would appreciate your prayers for a successful, natural delivery.  I am preparing mentally for every possibility, as I’ve said before, yet I remain hopeful that God will grant us this very strong desire of my heart.