Zatera Ul

The third trimester of this pregnancy is going ok so far. I’m only starting to feel huge, probably because I’ve only gained a couple of pounds (net) so far this time. Very unlike last time, but then I still have many of the pounds left over from last time. I’m not really in maternity clothes yet, just borrowing MFH’s shirts because mine are all too short.

The baby’s kicks have gone from little flutters to visible jabs to rolling-over churnings. It’s most active right around bedtime.

We haven’t even tried to think up names this time. We’ll just look at it when it’s born and pick a name that fits, I think.

OLC seems to be getting the general idea that a new baby is coming. We’ve been talking now and then about the baby and what will happen when the baby is born. She sometimes repeats back the whole story: “There’s baby in mom’s tummy growing bigger and bigger. One day baby be born. Say, ‘Wah, I don’t like this!’ Baby need lots and lots of foods [nursing]. Baby poop a lot.”

Since OLC weaned, her nap schedule has drifted more and more away from mine. And I have really been needing my naps lately.

We’re still not sure what we’re going to do with OLC while we’re doing the home birth. She doesn’t have a regular babysitter. Most of our friends live on the other side of the metro. Grandma is over an hour’s drive away and busy with her career. A doula would be expensive and probably more interested in helping with the birthing than with the babysitting. A babysitter probably wouldn’t be available in the middle of the night or most of the other random times that the baby might choose to come. So it looks like I’ll have to have the baby either while OLC is sleeping, or when she can be distracted with a video.

I’m waiting on my antibody screen results before getting the prenatal RhoGam. From all the ABO-incompatibility jaundice problems that we had last time, I had considered refusing it this time*, but it seems that we have a 50% chance of having a type O baby, and 75% chance of having an Rh-positive baby. So in all a 37.5% chance of having a type O+ baby, where RhoGam might actually be helpful. Knowing how it works, though, I’m not happy about it–RhoGam actually creates a temporary case of Rh-sensitization: its anti-D (anti-Rh-positive) antibodies can cross the placenta and attack the fetus’ blood cells, the only differences from real Rh-sensitization are that it is much, much milder and will go away between pregnancies.

*ABO-incompatibility (mom type O and baby not) has been shown to be somewhat beneficial in preventing Rh-sensitization. The reason is that type O moms may? usually? have some natural anti-A and anti-B antibodies in their blood. So if a fetal-maternal hemorrhage occurs (FMH; baby’s blood entering mother’s bloodstream) the mother’s own antibodies may be able to get rid of those blood cells before the immune system starts making a response against them on an Rh-incompatibility basis, thus avoiding sensitization. It’s not something that you can totally count on, but with our “severe” ABO-incompatibility jaundice that we had last time (moderate jaundice, in my opinion, from the baby getting some of my blood and antibodies at birth**), I’m pretty sure that I do have enough anti-A to be protective, and that RhoGam isn’t going to do anything for me that my blood can’t do for itself….WHEN the baby is Type A. But when the baby is Type O, there’s no ABO-incompatibility to protect us. If this baby is Type A+, I might refuse the postpartum shot; haven’t entirely thought that through yet.

I should add, too, that some (not all) anti-A and anti-B antibodies are of the kind that can cross the placenta too. But they attack all fetal cell types, not just red blood cells, so the damage is more spread out and less likely to be severe. That’s why ABO-incompatibility jaundice is generally milder than Rh-disease jaundice**.

**Pathological jaundice is from mother’s antibodies crossing over to the baby at birth and attacking the baby’s red blood cells. The liver breaks the destroyed blood cells down into bilirubin, the bilirubin makes the baby turn yellow and, very very very rarely, may cause brain damage or death.