Reassurance (Part Two): The BPP

I went in for my first biophysical profile (BPP) today. The BPP combines a non-stress test (where they hook me up to monitors for both the baby’s heartbeat and any possible contractions and then observe how his heart rate corresponds to his movements or contractions) with an ultrasound to check the amniotic fluid index. As I wrote before, these weekly checks are now recommended for all women over 35 once they’ve reached 36 weeks. My doctors were kind enough to let me start them at 33 weeks simply for the extra peace of mind they might provide.

I was not disappointed. With one small exception (something that was totally unrelated to the test itself), the entire experience was wonderful and I came away feeling completely and totally reassured and so very glad that I had asked for the early weekly monitoring.

The room where they do the test is dimly lit and contains three very comfortable reclining chairs, each one having its own testing equipment so three women can be monitored at once. When I first got there, I was the only person in the room, which ended up being a good thing. The technician put a blood pressure cuff on me and started it, and then, as she was working to get me hooked up to the monitors, she asked, “Is this the first baby for you?” I could certainly have guessed this was coming but hadn’t really thought about it in advance.

“No, my second.” And I started preparing for what I would say when the next inevitable questions came.

“And how old is your older child?”

“She actually passed away last year.” Tears start. There goes that “actually” again. “That’s why I’m here at 33 weeks—it’s more like the doctor is letting me come than making me come, because I have been so anxious during this pregnancy. Even though it wasn’t pregnancy-related. She got meningitis at 17 months old.” Tears really coming now. The tech, so very sympathetic, brought me some tissue and knelt back down in front of me.

“That must have been a terrible shock for you.”

“It was.”

“What was her name?” I was floored by this question. Not a single person with whom I’ve had this very difficult conversation has yet asked her name. I couldn’t believe what a difference it made and how warm it made me feel toward this person I didn’t even know.

“Hudson.” I fingered my necklace with her name on it, as I so often do (thank you again to my friend Andrea for such a lovely gift). “Thank you for asking. No one ever asks that. That’s really kind of you.” I can’t even remember what else we said, because I was still so surprised that she’d asked about Hudson’s name.

Then she looked at my blood pressure. 132/82. High, especially for me. “Well, we’ll hook you up again at the end and see what it says then.” I agreed this was a good idea since that reading had come right in the middle of my minor meltdown.

After all the monitors were hooked up, she gave me a little button to push whenever I perceived any movement. I could hear Jackson’s heartbeat pounding away out of the machine right next to my chair, which is always comforting, and I could see his heart rate accelerating every time he moved, which is really comforting. But the really incredible thing, the real takeaway from the day, was that I kept hearing him move even though I couldn’t feel him move. I’d read about other women’s experiences with this, but it was still amazing to witness it myself. It tells me two things—one, that he could be moving a lot more often than I ever realize, so I probably don’t need to worry quite so much when I don’t feel him move in the exact same patterns every day (although I’ll still keep doing my kick counts all day and calling if anything seems really significantly off), and two, that I probably don’t need to worry during those times when I can actually feel him moving like crazy, because he may be doing that a lot more often without me knowing it, too.

Like my friend Andrea suggested, though, the monitoring does come with a little bit of test anxiety. I thought it was so strange that I couldn’t always feel him moving, so I found that I was almost willing myself to feel the movements. It was much like what happens when I have to endure hearing tests as my hearing loss gets worse and worse. I sit in a stupid soundproof booth with headphones playing tones in my ears. They tell me to raise my hand whenever I hear something, so I end up practically straining my neck trying to hear things that I can’t and often raise my hand just because I think I should. I had to fight that impulse today, knowing that the monitor was picking up the movements even if I wasn’t.

Once the non-stress test was over, and I had been sitting there calmly for about 30 minutes, she checked my blood pressure again. “Wow. What a difference,” she said. “92/57. You can see why people have strokes when they get upset.” I was momentarily bothered by the possibility that my blood pressure has been rocketing up like that every single time over the last year that I have gotten really emotional (which is often several times a day, you know), but I got over that quickly. She showed me the test strip (a long piece of graphing paper that traced Jackson’s heartbeat above dark boxes that indicated his movements) and explained that everything looked good. There were hash marks at every spot where I had pressed the button indicating I had felt him move, and again, it was unreal to see how many more black boxes (actual movements) there were than hash marks (my perception of movements). It’s hard to describe how reassuring this was for me.

Then she did an ultrasound to check on the amniotic fluid again. It’s now around 15 cm, so down a little more from last week, but still plenty enough and well within normal range. And she gave me another picture in case anyone ever questions that I’m having a boy. Definitely a boy.

The only dark moment of the whole experience was when another woman, very pregnant, joined me in the monitoring room. She was 45 minutes late for her appointment, so the tech had to fit her in (and having to do things like that is one of the reasons I had to WAIT 45 minutes for my own appointment, for which I had arrived on time). But even worse, she reeked of cigarette smoke—I could smell it as soon as she walked in the room. I thought I should give her the benefit of the doubt—maybe she was a smoker before she got pregnant and her clothes were still stinky, or maybe she lived with a smoker, which isn’t great for her baby, but is not as bad as her smoking enough herself to smell that way. But then the tech asked her when she had last had a cigarette, because it could affect the readings, and she replied, “About seven this morning.” I gritted my teeth thinking about the unfairness of it all, thinking about all the women I know who have struggled so long and so hard to get pregnant at all, let alone carry a baby to term, who have restricted their diets and their activities and done any number of other extraordinary things in order to have a healthy child, and this woman is still smoking. I was thinking about all the women I know who have suffered devastating pregnancy losses, despite having done everything “right” from beginning to end, and this woman is still smoking. I thought about all the worrying I have done throughout this pregnancy with my sweet little boy for no real reason at all, and this woman is still smoking. I thought about all the organic food I fed Hudson, all the research about the safest car seats and other baby gear, all the vaccinations we made sure she got, the year’s worth of breastfeeding and pumping I did, the constant watch I kept, all just to have her die in the end of a rare aggressive bacterial infection that I could not prevent, and THIS WOMAN IS STILL SMOKING?!?!? As much as I hate myself for being so judgmental in situations like that, it was just too much. Of the many things I will never understand about the world and what happened to us, this has to be one of the worst. It’s a good thing the tech didn’t recheck my blood pressure at that moment, either.

But that’s not what I’m taking away from the day.  What I’m taking away is some satisfaction for having advocated for myself to get this extra reassurance, continued awe at the compassion of perfect strangers, and at least one more good night’s sleep.