ultrasound news

Dearest Bunny,

Yesterday was your first level two ultrasound. We drove an hour out of town to go to a maternal fetal medicine specialist - the same one we went to with your sister Lily and had briefly visited during my pregnancy with your brother Hayden.

In the past we have taken either Mackenzie or Josiah with us to these in-depth ultrasounds. When I was pregnant with Hayden we took Lily with us as well - to visit the doctors who had treated us during my pregnancy with her, and as living proof that Down syndrome was not something we feared. But this trip was just the two of us ... Daddy and I wanted to go to lunch afterwards, and also : his smart car only has room for two :)

necklace that Naomi made for me to wear to the ultrasound

We saw an intern for the first part of your ultrasound. She was young and personable and explained everything she was looking at as she went. I've had some pretty stoic ultrasound techs over the years - I like the friendly ones much better ! She squeezed the warm gel over my tummy and asked me several questions as she began moving the wand across me, first making sure there was a beating heart. I admit to always feeling just a twinge of nervousness in that first minute ... the only reassurance I have of a healthy baby inside me right now is an occasional flutter, and even those are fleeting at this stage. But the tech found your heartbeat right away, and she turned up the volume for Daddy and me to listen to - the perfect cadence of galloping hoof beats, measuring 150 per minute according to the number on the screen.

The scan continued, with Daddy and I taking turns whispering about how cute you were and marveling at how clear the image was that we were both looking at. The tech told us that their machines are the best there is - infinitely more precise than those first ultrasounds we had done over twenty years ago when I was pregnant with your oldest brothers and sister. You kicked and rolled, waved your arms and unfolded your legs repeatedly - you were very active in there, and you were taking full advantage of the room you had to stretch out in :)

The tech continued her measurements, documenting every limb and organ as she observed them...

"This is the right femur," she said, her fingers flying across the keyboard while she carefully clicked the beginning and end points of your leg bone. My eyes flew to the bottom of the screen, noting that your gestational age (15 weeks, 5 days) was a week ahead of the measurement she recorded. Lily's femurs and arm bones had been lagging by three weeks during her 28 week scan ... the doctor at that time had said it was possible that Daddy and Mommy's genes had more to do with her short limbs than an extra chromosome. Looking back it's so hard to see how there was any doubt, though. Although all of your siblings were on the small-to-average size, none of them had lagging arm or leg bones. I made a mental note to ask the doctor about the fact that your legs and arms were only a week behind, when Lily's had been three - I knew from past experience that ultrasound technicians are generally not allowed to answer specific medical questions when it came to diagnosing a baby in utero. As friendly and forthright as this technician was, I didn't want to cross that line.

Ten or fifteen minutes went by, when the regular technician came into the room. The intern quickly handed her the probe, and as she introduced herself, I recognized her from a previous ultrasound as well. She began remeasuring the same bones and organs that the intern had ... I watched carefully as she recorded in centimeters the width of one kidney, with the second kidney listed underneath. I remembered our first ultrasound with Lily, when one of the soft markers for Down syndrome had been "an enlarged kidney" - clearly you had the same marker, as evidenced by the mismatched numbers on the screen.

She measured the circumferences of your head and abdomen, and just as with your sister Lily, I noted that they both corresponded to your gestational age. I knew from weeks of researching online during my tenth pregnancy that this was typical in regards to Down syndrome - while the leg and arm bones may be lagging, the head and abdomen typically measure on track.

Halfway through the exam, the tech asked me to empty my bladder- you had been lying face down on your tummy the entire time, which limited the view of your little beating heart. I left the room and returned a few minutes later, and I rolled to my left side as instructed by the technician . We hoped to shake things up in there, but our little Bunny was quite content to stay lying on her tummy ! You rolled from side to side occasionally, folded and unfolded your limbs, stretched your tiny arms above and behind your head, waved your little fists in front of your face as if to say hi to Mommy and Daddy, and pressed your little toes against the wall of my uterus... but you stayed face down or on your side, refusing to roll over and show us your chest :) You are already one stubborn little Bunny, but that's okay - we knew we would be coming back in a month to get a better view of things anyway.

The tech finished up her measurements and told us the doctor would come back to the room after taking a look at the pictures ... Daddy and I waited patiently and talked quietly about what a little doll you are already. We were tickled by the fact that you had been opening and closing your mouth several times during the exam. While we never got to see your cute little profile, we did see the sweetest little hands and feet, and I could already imagine the day when those little fingers would curl around mine ... five more months seems such a long way away.

our bony little Bunny, opening and closing her mouth :)

The doctor came into the room- the same one we saw with Hayden three years ago. A cheerful, petite blond woman who is equally energetic and kind, she makes you feel as if you are only there to take a peek at your beautiful growing baby, rather than look for potential signs of danger on an ultrasound. She is the perfect antidote to any fears or anxieties a parent might experience when facing a new diagnosis - I wish every doctor in America had her bedside manner.

After re-introducing herself and asking us how Lily was doing (so nice that she remembered her and asked about her as well!) she quickly went over the results from the scan. We talked about the results from the NIPT test, and the fact that you most likely share your sister's extra chromosome - she mentioned almost off-handedly that there were lots of little indicators she saw on the pictures that lined up with the results from the screening. She then went on to point those out, and just as I suspected they were the following: shortened femurs and arm bones, enlarged kidney, echogenic focus on the heart (a non-threatening "bright spot" that your sister had as well), and one that I hadn't known was visible - missing pinkie bones ! One of the first things I noticed when Lily was born was the fact that her little pinkies were curved- although not all babies with Down syndrome share this trait, it is a common one, a result of a missing or shortened middle bone on the last finger. I hadn't known this was visible on an ultrasound - for some reason this little piece of information knit my heart even more tightly with yours, little Bunny. You are fearfully and wonderfully - and uniquely ! - made :)

The doctor went on to explain that right now your heart is smaller than a dime, making it extremely difficult to get a good view of because of the size. Compounded with the fact that you were lying on your tummy throughout the scan, the only view we got being the one through your tiny back and into the heart, she was not able to get a really accurate feel for how everything looks. She held her hand in front of her eyes, fingers spread apart, and explained that basically that's what it was like - looking through her splayed fingers to peek at what she saw. However, she did say that what she saw looked good : there were no red flags indicating that a stillbirth or other dangerous scenario was imminent .

And right here, dearest Bunny, I will say that your mommy had a little wave of fear wash over me. It was just for a moment- the statement our doctor made was meant as one of reassurance, and not alarm. But no mommy wants to hear the words stillbirth or danger in connection with her unborn baby ... I wish I could say my faith was unshakable in that moment, but the lump in my throat proved otherwise. She went on to say that she saw no fluid building up behind your brain- she explained that this can be a big sign that a baby's heart is failing and that there is a major defect present. The absence of any fluid was very reassuring, as well as the fact that there were no obvious defects on the heart that she could see it this point. She told us that other than the obvious markers that we had expected, you looked great – she had a big smile on her face and told us that we would see things more clearly as far as your heart goes, in four weeks when we come back for our next ultrasound.

I asked her about your leg measurements, and she explained that as you grow, your legs and arms will probably lag a bit more like Lily's did.

This ultrasound was so different than our initial one with Lily six years ago, Bunny. All of the markers we discussed, even the fact that there could be a heart defect that might show up in the future… all of it was lacking the fear that I felt in that room so long ago. Our dialogue about Down syndrome was no more intense than if we had been discussing the color of your eyes.

And I couldn't help but think how wonderful it would be every new diagnosis were able to be discussed in such a tone. I wonder how many new parents, when hearing the words Down syndrome for the first time in regards to their baby, would have a different outlook on their future, a different perspective on that diagnosis – if it were explained in the straightforward and gentle manner in which our doctor was speaking. The words we heard were not spoken in a morbid or somber tone – there were no veiled references to termination, no conversations about "quality of life"…we didn't leave that office feeling like we carried a burden with us, but rather a gift – we left with the truth.

That truth wasn't sugarcoated, the potential issues weren't glossed over, there was no stone left unturned… but there was a joy and expectancy in the room that every new parent should feel, and we left knowing that our doctor celebrated with us in the gift of life that we have been given ... the miracle of YOU.

Daddy and I drove a half an hour out of town, along the winding McKenzie River to a tiny restaurant tucked away in the dense Northwest forest. The restaurant (one of Daddy's clients) just opened up a few weeks ago, and it is the only place to eat that actually sits next to the river for sixty-nine miles. The food was wonderful, the weather divine, and the sound of rushing water made the perfect backdrop for our peaceful afternoon together.

We spent a leisurely lunch enjoying each other's company and talking about every aspect of this pregnancy.... what a miracle it is that we were able to conceive at our age, what a blessing it is to know ahead of time about your extra chromosome, how excited we are to experience everything we did with Lily as a baby - without the fear - and how happy we are knowing the joy that lies before us.