Pregnancy Sonograms: What You Will Learn- Part 2

by Elizabeth MacDonald
This post made possible by the generous support of My Baby’s Heartbeat Bear
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This article originally published on mybabysheartbeatbear.com on November 10, 2015.

 

In the article “Pregnancy Sonograms and What You Will Learn, Part 1” we talked about the different kinds of ultrasounds and their purpose, ending with more detail about the general anatomy scan common around 20 weeks of pregnancy. In this article, we’re taking a deeper look at the types of scans done prenatally and the reasons why your healthcare provider may recommend them as a diagnostic tool. These scans can provide valuable information on the health of your baby when necessary.

MBHBB- Preg. sonograms, June 2016

Your doctor or midwife may recommend one or more of the following sonograms throughout your pregnancy, for various reasons. You may not know when you conceived or may have suffered previous miscarriages. You may be over the age of 35 and your doctor requires extra screening. There may be genetic reasons for extra scans, or a low lying placenta that could threaten a vaginal delivery. Your little fetus may stubbornly decide to lay transverse and a late sonogram is needed to see position. There are numerous reasons to receive sonograms other than the 20 week anatomy scan.

  • Dating Scan: A dating scan is an ultrasound examination which is performed in order to establish the gestational age of the pregnancy. If you or your doctor/midwife is unsure of the date of your last menstrual cycle, if you have had an bleeding, are unsure of when you conceived or your estimated due date, you will receive a dating sonogram. This ultrasound will show you exactly how far along you are, and can see the start of a pregnancy as early as 4 weeks and 3 days along (but some pregnancy cannot be seen until 5 weeks). You will see the beginnings of a gestational sac, but no heartbeat or further fetal development yet at this stage. An embryo and fetal heartbeat can be detected as early as 6 weeks and 3 days, but may not be picked up until further along. You will also know the location of your pregnancy. If there is a chance that it is ectopic, you will find out now. At this stage of pregnancy, the dating scan will be done transvaginally, meaning the ultrasound wand will be inserted into the vagina to see the pregnancy. A dating scan can determine the number of gestational sacs present (which may decrease by the end of the 1st trimester, if there is more than one). Your cervix, uterus position, and ovaries will also be seen, and you will learn if there is any visible clotting or fibroids. A sonogram done before 9 weeks will be the most accurate to use for dating the pregnancy.
  • Breakdown of what can be seen:
    • At 5 ½ weeks gestation tiny sac can be seen in the uterus, but the baby and its heart beat may not be detected yet. 5 ½ weeks gestation means 5 ½ weeks from the first day of the last menstrual period, which is usually about 3 ½ weeks from the date of conception (confusing, isn’t it!).
    • By 6 to 7 weeks gestation the fetus is clearly seen on trans-vaginal ultrasound and the heart beat can be seen at this early stage (90 to 110 beats per minute under 6 to 7 weeks, then 110 to 200 beats per minute as the baby matures).
    • By 8 weeks gestationthe baby and its heart beat can be detected relatively easily with trans-abdominal and trans-vaginal examination.
    • This is presuming that the pregnancy is actually at this stage of development.
    • Sometimes a trans-vaginal examination shows that your pregnancy is less advanced than expected.
  • 1st Trimester Scan (Also known as a NT Scan): Having a transabdominal sonogram between 12-13 weeks is performed to confirm your baby’s heartbeat and conclude first trimester screening for chromosomal abnormalities. The screening is optional for one or all of the following: Down’s syndrome, Edward’s syndrome, and Patau’s syndrome. Down’s syndrome is also called Trisomy 21 or T21. Edwards’ syndrome is also called Trisomy 18 or T18, and Patau’s syndrome is also called Trisomy 13 or T13. The screening test offered at 11-14 weeks is called the combined test. It involves a blood test and an ultrasound scan. If a screening test shows that you have a higher risk of having a baby with Down’s, Edwards’ or Patau’s syndromes, you will be offered diagnostic tests to find out for certain if your baby has the condition. In addition to screening for these abnormalities, a portion of the test (known as the nuchal translucency) can assist in identifying other significant fetal abnormalities, such as cardiac disorders. The screening test does not detect neural tube defects. The combined accuracy rate for the screen to detect the chromosomal abnormalities mentioned above is approximately 85% with a false positive rate of 5%. A positive test means you have a 1/100 to 1/300 chance of experiencing one of the abnormalities.
  • Level II ScanWhile technically the anatomy scan is a Level II scan, there are other reasons to come in for a Level II sonogram. During your anatomy sonogram, you will learn if another Level II scan is needed. Level II scans are reserved for higher-risk mothers, but may be used to rule you out of the high-risk category. Common indications for a Level 2 ultrasound include family history of birth defects, maternal medical problems associated with birth defects (poorly controlled diabetes, for example), exposure to medications associated with birth defects, a maternal age of 35 or older, abnormal serum screening results, and birth defects suspected on a Level 1 ultrasound. While there is no ultrasound that can detect 100 percent of serious birth defects, most birth defects that are undetected with a Level 2 ultrasound usually are clinically less significant (such as a small hole in the heart which commonly closes on its own after birth or an isolated cleft palate with intact upper lip which can be fixed surgically after birth without any long-term complications). A survey of your baby’s internal organs will be conducted, as well as:
    • The umbilical cord
    • Amniotic fluid
    • Location of the placenta
    • Fetal heart rate

The total score will help decide the overall health and well-being of your baby and help your doctor or midwife determine if your baby should be delivered sooner than planned.

  • Bpp Scan (Biophysical Profile)This sonogram combines an ultrasound evaluation with a non-stress test (NST) and is intended to determine fetal health during the third trimester. This test is performed if there is a question about fetal health and well-being resulting from either an earlier examination, maternal/fetal symptoms, or if the pregnancy is considered high risk. There are two parts to the BPP, a Non-stress Test (NST) and an ultrasound evaluation. The NST involves attaching one belt to the mother’s abdomen to measure fetal heart rate, and another belt to measure contractions. Movement, heart rate and “reactivity” of heart rate to movement are measured for 20-30 minutes. The ultrasound portion may take up to an hour, and the technician will watch for a variety of signs that are important in measuring the health of your baby. Usually, five specific fetal attributes are studied and “scored” during the BPP:

Biophysical Attribute- MBHBB 06.16

  • NST Scan: The Fetal Non-Stress Test is a simple, non-invasive test performed in pregnancies over 28 weeks gestation. As mentioned above, The NST involves attaching a belt to the mother’s abdomen to measure fetal heart rate, and another belt to measure contractions. Movement, heart rate and “reactivity” of heart rate to movement are measured for 20-30 minutes. A NST may be performed if:
    • You sense the baby is not moving as frequently as usual
    • You are overdue
    • There is any reason to suspect the placenta is not functioning adequately
    • You are high risk for any other reason

The test can indicate if the baby is not receiving enough oxygen because of placental or umbilical cord problems; it can also indicate other types of fetal distressThe primary goal of the test is to measure the heart rate of the fetus in response to its own movements. Healthy babies will respond with an increased heart rate during times of movement, and the heart rate will decrease at rest. The concept behind a non-stress test is that adequate oxygen is required for fetal activity and heart rate to be within normal ranges. When oxygen levels are low, the fetus may not respond normally. Low oxygen levels can often be caused by problems with the placenta or umbilical cord.

Many pregnancies progress just fine without ever having an ultrasound and health care providers use a wide array of skills and tests to ensure the safety and health of both the mother and the baby through pregnancy and birth. Having any of these scans done isn’t immediately an indication of a problem, it is just an opportunity to check. It is a gift to hear your baby’s heartbeat and see them developing, one to treasure. While it can be exciting to hear your baby’s heartbeat and to see them on the screen, the purpose of ultrasounds is to be an important tool in your prenatal care, not an entertainment experience. They may provide some answers to questions and concerns, reveal a potential problem or that everything is developing normally, and provide reassurance. Be sure you are using a reputable ultrasound technician to perform your scans, your healthcare provider should refer you to one they trust and use regularly if it is out of office. If you feel that a scan is unnecessary and are unsure you want to go through with it, be sure to speak with your healthcare provider about your concerns to better understand the purpose of the scan. If at any point there is something you don’t understand, speak up and let your healthcare provider know you have questions.

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me
Elizabeth is mom to four breathtakingly-beautiful children, and wife to one lucky man. She is a research writer, blogger, and a ghost writer of books.  As a natural-minded woman, Elizabeth takes pride in spreading factual information that may benefit other mothers and future generations.  She has spent the last seven years (and counting) growing babies in the womb and/or with breastmilk.  When she is not writing, she enjoys drinking wine, running, cooking, reading, homeschooling, and loving her family and friends.

Pregnancy Sonograms: What You Will Learn- Part 1

This post made possible by the generous support of My Baby’s Heartbeat Bear
IMG_4531
This article originally published on mybabysheartbeatbear.com on November 10, 2015.

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There is something so exciting about seeing your little jelly bean bouncing around on the ultrasound screen! Counting down the days until you can watch your baby swim around is something almost all couples do.You get pictures and possibly a video with the heartbeat. All of it just solidifies that you truly are carrying a little life inside.

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Healthy, low-risk pregnant women are recommended to only receive a sonogram at 20 weeks, but there are times when other scans are needed to check on the baby. There are six common sonograms performed throughout pregnancies, and one or more may be recommended to you. I’m going to break them down and explain their individual purposes and what you can expect to leave knowing after having one.

Before describing the sonograms in the next article, in this first article we’re going to talk about the difference between a sonogram and an ultrasound and explain the most common sonograms utilized in prenatal care. A sonogram is the image generated during ultrasonography, which is a diagnostic imaging technique that uses ultrasound to visualize anything inside the body. Ultrasound is a sound frequency above the range audible to humans, which is about 20 kHz. Both terms are used interchangeably by most people, but in layman’s terms an ultrasound is using sound waves to see or hear something inside the body. A sonogram is the actual visual picture of what the ultrasound is picking up. There are seven types of ultrasounds that may be performed during pregnancy:

Standard Ultrasound  Traditional ultrasound exam which uses a transducer over the abdomen to generate 2-D images of the developing fetus .

Advanced Ultrasound – This exam is similar to the standard ultrasound, but the exam targets a suspected problem and uses more sophisticated equipment.

Doppler Ultrasound   This imaging procedure measures slight changes in the frequency of the ultrasound waves as they bounce off moving objects, such as blood cells.

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3-D Ultrasound  Uses specially designed probes and software to generate 3-D images of the developing fetus.

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4-D or Dynamic 3-D Ultrasound  Uses specially designed scanners to look at the face and movements of the baby prior to delivery.

Fetal Echocardiography  Uses ultrasound waves to assess the baby’s heart anatomy and function. This is used to help assess suspected congenital heart defects.

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Your doctor or midwife will likely use the Doppler during each prenatal visit to pick up the baby’s heartbeat. Generally, they keep it short and use this as reassurance to you that your baby is doing well. This is very common, but can be denied if you feel the urge not to have it done. (As an almost fourth time mom here, I’ll tell you just how amazing it is to hear that little heartbeat every few weeks!)

While many women will receive other ultrasounds during their pregnancy, other than the Doppler to check heart tone at prenatal exams, the standard ultrasound anatomy scan around 20 weeks is the most common. See below for more information about the anatomy scan.

  • Anatomy Scan: Between 18-21 weeks, you will have a more in-depth ultrasound done to determine the baby’s size, weight, and to measure growth ensuring the fetus is developing according to plan. In addition, the anatomic ultrasound looks at and takes measurements of many different anatomic parts of the fetus. The technician or the doctor will be looking for any signs of slower than normal development. The skeleton should be hardening at this point and the sex of the baby may be visible. In many cases, the baby may have its legs crossed or be facing away from the abdomen and thus the sexual organs will not be visible during the anatomic ultrasound. But fingers crossed, you will learn the gender! On the plus side, you’ll receive many pictures of your little one during this scan. The following fetal parts are checked during the anatomy ultrasound:
    • Face: Depending on the positioning of your baby, the technician may or may not be able to detect if your baby has a cleft lip. Rarely are they able to detect if there is a cleft of the palate.
    • Brain: The technician will be assessing the fluid-filled spaces inside the brain and the shape of the cerebellum, which is in the back of the brain. He or she will also be able to identify if any cysts are in the choroid plexus, which is a tissue in the brain that produces cerebrospinal fluid. Fetal cysts may indicate an increased risk for a chromosome abnormality; however, the majority of these cysts disappear by the 28th week of pregnancy with no effect on the baby.
    • Skull (shape, integrity, BPD and HC measurements)
    • Neck (nuchal fold thickness)
    • Spine: Your baby’s spine will be evaluated in the long view and in a cross section. The technician will be looking to make sure that the vertebrae are in alignment and that the skin covers the spine at the back.
    • Heart (rate, rhythm, 4-chamber views, outflow tract): Congenital Heart Defects are one of the leading causes of birth defects and infant death. A prenatal diagnosis can prepare you and your medical team to provide your infant with the best medical care possible throughout your pregnancy and after birth.
    • Thorax (shape, lungs, diaphragm)
    • Abdomen (stomach, kidneys, liver, bladder, wall, umbilicus, cord, abdominal circumference AC)
    • Limbs (femur, tibia, fibia, humerus, radius, ulna, hands, feet, femur length FL)
    • Genitals (gender, abnormality)
    • Cervix (length and opening)

Based upon the results of the measurements, the gestational age of the baby will be predicted based upon the average size of other babies scanned during the 20th week of pregnancy. If any abnormalities are found, additional examinations are indicated.

In our next article, we’ll go more in depth into the other Sonograms some women experience in pregnancy and their purpose. No matter what kind of scan you’re given, it can be an exciting time and a bit of an emotional roller coaster. Hearing and seeing how your baby is doing can be both nerve-wrecking and encouraging. Read here for more potential emotional impact of a prenatal ultrasound experience.

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me
Elizabeth is mom to four breathtakingly-beautiful children, and wife to one lucky man. She is a research writer, blogger, and a ghost writer of books.  As a natural-minded woman, Elizabeth takes pride in spreading factual information that may benefit other mothers and future generations.  She has spent the last seven years (and counting) growing babies in the womb and/or with breastmilk.  When she is not writing, she enjoys drinking wine, running, cooking, reading, homeschooling, and loving her family and friends.

Exploring The Potential Emotional Impact Of The Prenatal Ultrasound

This post made possible by the generous support of My Baby’s Heartbeat Bear
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This article originally published on mybabysheartbeatbear.com on January 2, 2016.

 

The day has come to say hello, to see the one who’s still so small.

A heartbeat will bring many tears, but still will come all the fears.

Will she grow strong and tall? Will we lose him… and my heart will fall?

Are there two or three? Will my birth choice be mine to make free?

My arms ache to hold you. My heart aches to know you.

Above all else though, I know you are mine.

I will love you in every way, no matter what the doctor will say.

Today is the day that I will see your face, tiny and real, you will move to a place

A place in my heart I had never found…

Until today’s ultrasound.

-E.MacDonald

Ultrasound

Ultrasound Day:

Seeing a heartbeat.

Seeing multiple heartbeats.

Not seeing a heartbeat at all.

Revealing a gender.

Fighting the urge to discover the gender.

Learning devastating news.

Counting ten fingers and toes.

There is no denying that a pregnancy ultrasound will change your life.  While most women may check it off as just another day of pregnancy, even seeing a healthy little baby swim around should spark a light of life-changing emotions. The miracle of life is one our society tends to shrug off and sometimes the effects can cause us to become unaware of how we truly feel towards seeing this tiny human being on a screen.

Technology is a wonderful (and scary) tool.  We learn so much in a matter of moments, whether it is a healthy or unhealthy pregnancy, if baby is growing well, whether vaginal labor will be a safe option, if the gender we dreamt of is what exists, and if everything is okay with the mother.  Primarily a diagnostic tool, the necessity of prenatal ultrasounds may be heavily debated but there is no doubt that as routine as they have become, the prenatal ultrasound is a significant moment in the lives of parents-to-be while providing information to care-givers to help the parents make informed decisions.  Along with this education comes the anxiety and fears before the truth is learned.  And what’s worse is that after this brief moment of time, the heart and mind will create a new laundry list of emotions based off of what was discovered during the ultrasound.

Let me state this: There is no right or wrong emotion to feel – Sadness to be pregnant, panic to be pregnant with multiples, triumph to have a healthy baby past a certain date, pride that you created this being, even confusion on whether to keep or adopt.  Emotions are a very personal thing, and you have a right to not feel guilty about any of them.

It is ok to let the tears fall.

A Healthy Pregnancy:  A healthy “typical” ultrasound will have you crying tears of joy; especially if you were terrified going into it.  It can also leave a woman experiencing an unplanned pregnancy in agony, as she will be filled with choices, fears, and guilt.

Multiples: Multiple heartbeats found on the screen may lead to disbelief, panic, excitement, and many many questions. Fear of placenta(s) and sac(s) and nutrients may dance through your mind endlessly.

An Unhealthy or High Risk Pregnancy:  Knowing you will be closely monitored may either be reassuring or cause further anxiety.  When the baby or mother is at risk, the emotional rollercoaster typically picks up quite a few more passengers. Bearing the weight of your own emotions, along with your family and friends will become all encompassing. Reaching out for support and having a safe sounding board to cry to will allow you the ability to have the healthiest version of this pregnancy possible.

A Miscarriage: Expecting to see a flicker of blinking light on the screen where there is none can be devastating.  It doesn’t matter if you are 9 weeks or 15 weeks when you see that the life you thought was growing has stopped. You are no less of a mother. It does not matter that others say, “The next one will stick” or “At least it ended this way instead of a sick baby.”  There was life within you.  Mourn in the ways you need to.

A Pending Loss:  To learn that your child will not survive the pregnancy will bring forth unexpected emotions – Joy that you will still have time to grow and love this baby, but so much heartache that you will never know him earth side.  There will be anger and fear, but hope that things will change. There will be days of normalcy, but so many of confusion and pain.

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A Genetic Marker or Cause for Concern:  Sheer panic may occur; heart-racing fears and a lifetime of scary images may cross your mind.  Stress will be unavoidable, but handling it well will be needed.  Further testing will be done, causing more emotions, more tears, and more prayers.

Gender Disappointment:  Gender disappointment is real. (Ask me how I know.) No one should make you feel guilty for your feelings of desire toward a certain gender. You know that you will love the baby that is growing, and that he was meant to be.  However, the heart will mourn the fact that you will not have ribbons and bows and tutus.  Taking the time to let go of those feelings will help you welcome the baby you are growing without resentment or sadness.

Placenta Complications:  A healthy baby.  A healthy mother. But a placenta that is covering the cervix or attached to the uterine wall improperly. This is a recipe for a mess of emotions.  Knowing everyone is absolutely healthy is reason enough to yell from the roof tops, but knowing there is absolutely nothing you can do to prevent a cesarean section from occurring will bring about lots of birth emotions and fears.

Fetal Positioning:  While at a normal 20 week ultrasound, there is no need for baby to be in birth position, if your midwife or doctor suspects an awkward position later in pregnancy, an ultrasound will be done to verify.  If you are planning a natural birth, this ultrasound may send you into panic mode.  There is always time, even during labor, for baby to turn correctly, but the fears will be real.  Letting go of stress will help the body relax, chiropractic care, specific exercises, and manual manipulation are all available to help.

No matter what you learn during your ultrasound, your pregnancy journey will be changed.  Sorting the emotions will be an ongoing (and hormonal) battle that can potentially affect your labor and delivery. Taking the time to accept your feelings and live through them will benefit your mind body and soul.  Try to handle your emotions by talking through them, living a healthy lifestyle, practicing a mind-centering exercise such as yoga, seeking acupuncture or chiropractic care, and finding support.  Your pregnancy and baby will be all the stronger if you can do this.

May your ultrasound be filled with many happy emotions, but be real with yourself.  Do not hide or feel ashamed with any emotion that comes rolling out.  Find support if you feel alone in your emotions.  Share your fears and sadness right alongside of the joy and excitement.  Let sorrows be known and heartache be felt for you will not truly experience the highest level of happiness until you have worked through all of your other emotions.

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me
Elizabeth is mom to four breathtakingly-beautiful children, and wife to one lucky man. She is a research writer, blogger, and a ghost writer of books.  As a natural-minded woman, Elizabeth takes pride in spreading factual information that may benefit other mothers and future generations.  She has spent the last seven years (and counting) growing babies in the womb and/or with breastmilk.  When she is not writing, she enjoys drinking wine, running, cooking, reading, homeschooling, and loving her family and friends.

My Baby’s Heartbeat Bear giveaway and breastfeeding in special situations live chat archive

My Baby’s Heartbeat Bear is giving away a frog kits to 5 lucky Leakies!  One of those very special moments for expecting families is when you get to hear your growing baby’s heartbeat for the first time.  And the second time.  And every time after that.  There is something beautiful and moving about hearing the steady rhythm of your developing baby’s heart, indicating life, strength and health.  As an ultrasound tech, Purusha has enjoyed this experience over and over and over again, and it created in her a desire to provide a way for all these families to be able to take that life-sound home in a quality, cuddly, snuggly way, and keep it forever.  This is how My Baby’s Heartbeat Bear was born.  As a breastfeeding mother herself, Purusha has experienced not only this joy herself personally but also became aquatinted with breastfeeding in the face of special challenges when she had twins.  My Baby’s Heartbeat Bear sponsored a chat on TLB with Star Rodriguez, IBCLC, on the variety of unique challenges from multiples to NICU to health issues for mom and baby.  I’m so grateful for the support of My Baby’s Heartbeat Bear for TLB and all Leakies and hope you enjoy the interview and giveaway.

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Breastfeeding multiples and other special situations live chat with My Baby’s Heartbeat Bear and Star Rodriguez, IBCLC archive.

Introductions and personal experience

Breastfeeding multiples, challenges, tips, and tandem feeding

NICU babies and pumping in special circumstances

Dealing with the reality, finding out about special circumstances such as multiples or special needs, etc.

Health issues for mom and breastfeeding

Support, finding receiving, and advice for the mom facing a special situation

General questions included conversation about surgery for mom, baby with spina bifida, and cleft lip.

 

My Baby’s Heartbeat Bear is giving away 5 frog kits as part of the live chat.  Use the widget below to enter.  Please go to My Baby’s Heartbeat Bear’s Facebook page and thank Purusha for her support of TLB and this giveaway opportunity.

stuffed frog, frog plush

 

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My Baby’s Heartbeat Bear Give-away

One of those very special moments for expecting families is when you get to hear your growing baby’s heartbeat for the first time.  And the second time.  And every time after that.  There is something beautiful and moving about hearing the steady rhythm of your developing baby’s heart, indicating life, strength and health.  As an ultrasound tech, Purusha has enjoyed this experience over and over and over again, and created in her a desire to provide a way for all these families to be able to take that life-sound home in a quality, cuddly, snuggly way, and keep it forever.  This is how My Baby’s Heartbeat Bear was born.  As a new sponsor on TLB, Purusha is offering our Leakies a look into who she is, what her hopes are for My Baby’s Heartbeat Bear, and a chance for 3 Leakies to win one of her cute, recordable animals.  These darlings are a great baby gift idea as well!   I’m so grateful for the support of My Baby’s Heartbeat Bear for TLB and all Leakies and hope you enjoy the interview and giveaway.

TLB:  What would you like readers to know about your company?

Purusha:  My Baby’s Heartbeat Bear offers expectant mothers a way to capture the sound of their baby’s heartbeat in an adorable stuffed animal to create a unique pregnancy keepsake. We have a large variety of animals to choose from including a monkey, elephant, giraffe, owls, bears, and many more. We recently added an Angel Bear that was created for a mother carrying a baby unable to survive outside the womb, and our Soothing Sounds bear for children with sensory issues that are comforted by certain sounds (mothers voice, rain, white noise.)

TLB:  How did My Baby’s Heartbeat Bear come about?

Purusha:  Working as an Ultrasound Tech in a busy OB office I am in contact with many expectant mothers. I had a patient tell me about a friend that had her baby’s heartbeat recorded in a stuffed bear. I was determined to find these bears and make them available to my patients! I did a lot of research and found stuffed animals that really did not meet my standards of quality for such a special keepsake. I decided I had to create my own line of heartbeat animal kits and make them available to every expectant mother out there. It has been a lot of fun creating keepsakes that bring so many smiles!

TLB:  How do you balance being a mom and running your own company?

Purusha:  Ugh! This is tough! I am a single mother of 9 year old boy/girl twins and struggle with finding balance often. I try to work as hard as I can when my kids are with their dad so I can concentrate on them when they are with me. There have been many nights I’ve laid in bed wondering if I made the right decision taking on the challenge of running my own business. I have come to realize my children love seeing me happy and are just as proud of me as I am of them. Although at times it may be stressful, overall it is still a lot of fun and I wouldn’t have it any other way.

TLB:  What are your favorite breastfeeding memories as a mom?

Purusha:  I nursed my twins for over 10 months and really loved it. I remember their little hands reaching for my face as we stared in each others eyes and the comfort it brought to them when nothing else would calm them. At 4 months my babies were too big to tandem nurse and I had to start nursing them separately. This was guaranteed one on one time with me and each baby. I am so grateful I have those memories and preach to ALL my patients that breastfeeding can really be a wonderful experience, even with multiples!

TLB:  What is one tip that helped you in your breastfeeding journey that you’d like to pass on to other moms?

Purusha:  Your body was made to feed your baby! It isn’t always easy, and may require a lot of work, but with time this will get easier and you will eventually look back on these days and be proud of the work you put into this.


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Purusha is giving away 3 fuzzy and cuddly prizes:

1. The Soothing Sounds Bear includes a 16″ white or honey bear dressed in a My Baby’s Heartbeat Bear puzzle piece jumper, red heart recording module, and protective vinyl storage bag. Choose to have your bear come with the soothing sound of a heartbeat or no recording and record your own soothing sounds later.  Retail value: $39.95

2. The Monkey Kit includes an adorable brown monkey, a special heartshaped recorder to capture the sound of your baby’s heartbeat in the womb, and a protective vinyl storage bag. The monkey is a very soft fleece-like material with poly fiber stuffing, and a velcro closure opening in the back where you can place the recorded heartbeat. “Monk” is approximately 16 inches tall. Retail value: $35.00 

3. The My Baby’s Heartbeat Bear Giraffe kit includes a 16″ stuffed giraffe, a special red heart recordable sound module, and protective vinyl storage bag. My Baby’s Heartbeat Bear kits make the perfect baby shower gift and pregnancy keepsake. Also available at many 3D Ultrasound Studios! Retail Value: $35.00


Currently Leakies can find these and other great products on the My Baby’s Heartbeat Bear website.

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Good luck to everyone!  Please use the widget below to be entered and have fun browsing www.mybabysheartbeatbear.com.  The giveaway is open from August 7, 2012 to July 15, 2012.  My Baby’s Heartbeat Bear is still a new sponsor and this is their very first give-away with TLB!  A big thanks to Purusha for her ongoing support of TLB and all breastfeeding women, please be sure to visit their Facebook page and thank them for their support of TLB and this giveaway opportunity.

This giveaway is open to international entries.

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Why find out?

After sharing my thoughts on the sex of this baby and finding out (Blue hair, ultrasound, 5 girls, and Sugarbaby) I had a lot of questions asking if we don’t care what the sex is, why find out?

I’ve talked before and openly about my pregnancies and having to deal with Hyperemesis Gravidarum (HG) through out them.  To sum it up, HG is severe nausea and vomiting in pregnancy, beyond the normal morning sickness levels, that usually results in a more than 10% weight loss for the mother, poor nutrition, dehydration, and other complications.  It’s like food poisoning that stretches on for months, for me personally it’s looked like vomiting 20-30 times a day and getting down to as low as 83 pounds.  Thanks to aggressive preventative care, this time I’ve only lost 16 pounds and with regular daily fluids through my PICC line, I’ve not dealt with severe dehydration.  At this point (over 20 weeks) I’m doing better than I ever have in one of my pregnancies and am down to vomiting 3-4 times a day and  for the most part I am able to function.

Still, it’s not easy and I have to admit to feeling more like I’m managing an illness than like I’m having a baby.  Because right now, that’s exactly what I’m most focused on, managing an illness.  Sugarbaby moves and kicks a lot and my belly is growing but I feel far more connected to my PICC line than I do the child growing inside of me.  I’ve even considered naming it, the line that is.  I have named my puke bucket in the past, so deep was the connection there.

There are reasons to be concerned about ultrasounds and like many in the natural birth community, I have my reservations about routine ultrasounds in pregnancy.  I’d share links to articles and research on the issue but I’m avoiding them right now since I’m about to go have one.  But do a search, there are plenty out there.

So why would I do an ultrasound if I have concern about their safety in pregnancy?  Aside from the fact that it’s only one ultrasound we plan on having during the entire pregnancy unless medically indicated otherwise, I have my reasons.  In my experience I have seen that a pregnant woman’s mind can greatly influence her pregnancy and her birth.  We have not had ultrasounds with each of our babies, with two we felt there was no medical reason to do so.  But then we discovered something: I struggled more with depression and feeling connected to my baby both during and immediately following the pregnancy when we didn’t find out than when we did.  There comes a point where I need something to help me start knowing the person I’m growing and connecting with them more than I’m connected to my IVs.  Knowing the sex of the individual growing inside of me is like a surge of power between me and my baby, energizing my connection and helping me get excited about having them.  That excitement helps make managing my HG this small challenge along the journey of getting this person.  The tiny potential risk of one ultrasound that gives us that connection as well as the peace of mind that the medications I’m on aren’t causing my baby to grow a second head means lower stress levels, higher endorphins, and begins the emotional journey from “I’m sick” to “we’re having a baby!”

With each of my pregnancies I find I worry more that something is wrong with my baby.  I used to think it was that I know more but now I think it’s not that complex.  We’ve had 5 healthy babies (Smunchie does have a minor heart defect and it was difficult and scary for a few months) and I start thinking there’s no way we’re going to have a 6th healthy baby.  Each time I imagine something worse.  Silly?  Probably.  Very real to me?  Yep.  And so, to help me sleep and to lower my anxiety, silly though it may be, we get the scan.  What if we do have a baby that is going to have special needs?  Well, things will proceed as already planned and we’ll start learning about navigating the world of parenting a child with special needs.  That’s not the problem for me, it’s the not knowing and the imagining that is.  Boy, girl, perfectly healthy, or special needs, this baby is ours and we love it very much, none of that’s going to change.

One more question that I’ve been asked frequently and I know goes unasked even more frequently: why keep having babies when you’re pregnancies are so rough?  The short, easy answer is because I’m crazy.  The longer, more complicated answer is that for me personally, I didn’t want HG to have the say in our family planning.  Our family didn’t feel complete.  We considered adoption and had actually planned on adopting but that didn’t work out.  So here we are.  It has been a difficult decision but one I don’t regret.  Getting through each pregnancy is hell, I won’t lie, and I hate the stress it puts on my family.  But we weren’t done, so we’ve walked through it.  I know it’s not for everyone and I grieve with my HG sisters that want more children but can’t make the HG journey again.  I feel incredibly blessed.

Please, if you or someone you know struggles with vomiting and nausea in pregnancy, please visit helpher.org for information on HG.  While care and treatment of HG is improving, it has long been misunderstood, left undiagnosed, and poorly treated.  Check this list to see if what you’re dealing with is normal morning sickness or HG.

Blue hair, ultrasound, 5 girls, and Sugarbaby

This past week I dyed my hair blue.  Well, really teal and only chunks, not all of my hair.  I did this for no other reason than I wanted to and I needed to do something fun for me.  Being sick this long with pregnancy can get draining and getting in touch with my fun, pretty, living side seemed like a good step at the half way point of this pregnancy.  I thought nothing of it, dyed my hair, snapped a few pics, and shared with friends, family, and the online world.

Two things happened that surprised me.

1.  Some people were shocked, apparently they thought I was normal?

What does that even mean?

2.  I was asked if this meant we were having a boy.

Hmmmm… I never saw that second one coming.  The thought didn’t even occur to me, though I probably should have guessed some people would think that.  I am well aware, painfully so, that our culture places a heavy emphasis on blue for boys and pink for girls but since we don’t personally buy into, encourage, or support gender specific colors at all in our family, I sometimes forget that other people do.  But in our family, we all rock the colors we love just because we like them.  A favorite phrase around here is “pink doesn’t have a vagina and blue doesn’t have a penis and they don’t care what you have.”  We truly don’t believe that even a quick look at history or cultures reveal that color preference has any bearing on a child’s developing understanding of gender, who they are, and if they are male or female.  Nor do we believe there is any reason that one’s gender has any bearing on one’s color preference.  So instead of embracing what has essentially becoming a marketing gimmick designed to increase sales through “gender specific” individualized items, we just try to like what we like and be who we are.  Even if that means I have blue hair.  In our house, all colors are gender neutral, they are, after all, just colors.  By the way, we apply the same thinking to sparkles, flowers, bows, trucks, cars, trains, music, and any other inanimate object and our daughters interact with “boy” and “girl” play things equally.  We have what some would consider “girly girls” and some “tomboys;” both terms I hate since I don’t understand why they can’t just be “girls.”  They are each so different, so them, that their sex seems inconsequential.  Besides, this whole pink for girls, blue for boys thing is relatively new in the history of humanity.  Meaning it was all made up in the last 100 years anyway.  I love this article from Smithsonian.com looking at the history of assigned colors for specific sexes, specifically for baby boys and girls.

“It’s really a story of what happened to neutral clothing,” says Paoletti, who has explored the meaning of children’s clothing for 30 years. For centuries, she says, children wore dainty white dresses up to age 6. “What was once a matter of practicality—you dress your baby in white dresses and diapers; white cotton can be bleached—became a matter of ‘Oh my God, if I dress my baby in the wrong thing, they’ll grow up perverted,’ ” Paoletti says.  

I have to admit, I just find that whole fear the kid will be “perverted” if they are dressed in or play with items of the “wrong” color just silly and potentially seriously damaging.  The biggest problem I see with this whole ridiculous gender color thing is that much of society buys into the marketing hook line and sinker which means if you have a boy that loves pink and has a thing for sparkles he’s likely to face merciless teasing and unfortunately not just from his peers but likely from the adults in his life as well.

So far we bat for “team pink.”  Which I think is a stupid way of saying we have all girls.  Not thinking of the sexes as teams playing against each other in the great game of life I don’t understand this analogy nor do I quite grasp the desire for one sex over the other either way.  I know it’s real and I see many times parents hoping for a boy/girl and sometimes dealing with what has been called “gender disappointment” when they discover they’re not getting what they hoped for in terms of their expected child’s sex.  But I can’t even begin to identify with it.  Even more confusing is the fact there are quite a few people that assume The Piano Man and I know it all too well, that we are grieved to not have a son.  Worse, is that so many assume we’re having another child in an attempt to have a boy.

I’m not going to lie, this assumption angers me.  Chest tightening, face flushing, royally pisses me off.  In spite of telling myself these people mean well and are just curious, all I really hear is that we should somehow, for some reason be disappointed that we only have girls.  That this disappointment fuels our family planning decisions, the quest for having a child with the “right” genitals justifying adding to our family.  We have never considered having another child just because we wanted the other sex and we never would.  Back when we were adding baby #5 I had become practiced in hiding my feelings when such stupidity flew out of insensitive people’s mouths until one day when our 4 big girls were with us and we experienced a conversation that went something like this:

Woman:  “My, that’s a lot of girls, I hope dad is finally getting his boy this time.”

Me:  “We’re excited to be adding another little girl to our family.”

Woman:  “Oh you poor man!  You’ll just have to try again, so outnumbered.”

The Piano Man:  awkward laugh “I’m ok, love my girls.”

Woman:  “Of course, but every man needs a son, it’s just not the same.”

We awkwardly move away, ending the conversation.

The Storyteller, then age 8, comes up to The Piano Man and sliding her hand into his says:  “I’m sorry I’m not a boy daddy.  I wish I was a boy so you wouldn’t be disappointed and so alone.”  In a flash he held her close, looked into her eyes, and told her that woman was ridiculous.  The girls proceeded to tell us how they felt like everyone felt sorry for their daddy because he must be sad to not have a boy.  He assured them that he never had wanted a boy, he had only wanted them.

I never hid my feelings again.  Regardless of how well intentioned they are, someone says something insensitive about how we must want a boy, and they have positioned themselves in the direct line of fire of my pink and blue fast ball of correction as to just how stupid that assumption is and how hurtful it can be to my daughters.  If my daughters are present for the exchange it is possible I will be even more forceful and look for an apology directed to my 5 fabulous girls that my husband and I don’t regret in the slightest.  And don’t you dare pity my husband, he’s not outnumbered, this is his amazing family and we’re all on the same team.  “So screw you and your narrow minded views” might just be my ending flourish.  Not exactly eloquent but pretty to the point.

We are in no way, nor have we ever been, disappointed that we have not had a boy.  Nor have we ever decided to have another child in an attempt to have a boy.

Please note, I don’t look down on, judge, or think I’m better than someone that has been disappointed with not having the sex they had hoped for.  Everyone’s feelings are their own and just are what they are.  Given our society’s obsession with how we define the sexes, I don’t think it is surprising that some would be disappointed to not have one or the other.

For many people it is a big deal, I get that.  I understand it, even if I can’t identify with it.  Socially it is accepted that we’re going to at least want one of each sex and all that we associate culturally with the different sexes.  Sugar and spice and everything nice = girl.  Frogs and snails and puppy dog tails = boy.  Yes, we think it’s bullshit but for many it’s very real.  How I wish we could let go of our expectations and the marketing and just accept our children for who they are, not some narrow list of culturally defined expectations based on their sex but a rather embrace a complex range of individuality that may be influenced by their hormonal makeup without being all that is to them, their tastes, their activities, and their preferences.  Male and female are biological, masculine and feminine are cultural.  The range of masculine and feminine is huge, if we must pigeon hole them we need to at least recognize that the hole is so big we can’t even begin to narrowly define it.  I know how damaging it can be to individuals; as a woman that has long struggled with not enjoying being “nurturing” and other typically feminine defined character traits and interests, I’ve dealt with insecurities that maybe I’m not a “real woman.”  And I’m married to a man that is incredibly nurturing and not strong on many typically masculine defined character traits and interests, he’s dealt with insecurities that maybe he’s not a “real man.”  I can assure you, he is most definitely a real man and he tells me that I am most assuredly a real woman.

Tomorrow we find out Sugarbaby’s sex, provided Sugarbaby cooperates during the ultrasound, and yes, we do this even though we don’t care what sex this baby is (I explain why this is important to us here.)  I’ll go out on a limb and say what I think it is, knowing full well I could be wrong.  Since I first suspected I was pregnant I have felt this baby is another girl.  In fact, I feel I’ve known her name since I was in labor with Smunchie.  Even though I’ve been correct with all 5 girls before now, I wonder often if I’m wrong and “girl” is just my default setting after having 5 girls.  But I could be wrong and I would be more than fine with that.  Because it doesn’t matter to me.  All the big girls think girl too but they are open to having a brother, there will be no disappointment either way.  If Sugarbaby is a boy I would look forward to The Piano Man and I getting to raise a counter cultural son, just like we have enjoyed raising counter cultural daughters.  Another child embraced to be who they are, to buck cultural constructs defining their sex, and to enjoy discovering their unique personalities and interests.  Whatever sex, Sugarbaby is going to greatly enrich our family.

See Sugarbaby’s pregnancy announcement video here.

There are people rooting for us to have a boy, I know.  They want to see us have to “deal” with the shock having a boy would be after all these girls and think it would just be fun.  I figure having a boy will be a lot like having a girl, particularly at first and since we don’t plan on parenting differently based on the baby’s sex but rather adjusting our parenting based on the child’s individual needs the way we see it is it’s going to be an adjustment no matter what.  A wonderful adjustment, boy or girl, change is change and adding a family member is always a transition.  For a long time we always said we saw ourselves as “girl people” and even before we had children, we only imagined ourselves with girls.  Now I’m not even sure what that means, nor do I care since our daughters have taught us “girl” offers a huge range in personalities, interests, and actions.  Given that I’ve had my girls do all the typically considered “boy” things, including a big sister talking a little sister into getting into the toilet and flushing it to see what would happen, I’m confident we’ll be fine no matter what Sugarbaby throws at us.  Bring it kiddo, let’s have fun!

There is one major challenge I see if Sugarbaby is a boy: names.  Other than the one boy name we’ve had in our back pocket for the past 13 years of having babies, we just don’t have a boy name we love and we never have.  We joke that if Sugarbaby is a boy we’ll end up with Ophélia, Lavinia, Helena, Evangeline, Cosette, and Bob.  Or maybe George.  But Bob or George, there will be no fear of pink (or blue) here!

We will probably make an announcement of Sugarbaby’s sex at some point once we know but it will be a while yet.  Here’s what we did for Smunchie’s: