Pregnancy Life: First Trimester

After getting ready to try for so long, then putting my preparations into high gear and trying to conceive earlier than planned, and then trying to conceive for 10 months, I am finally pregnant and nearing the end of the first trimester!  Hopefully I will go back and have time to share more about my TTC experience at a later date, but at this point I want to focus in on my experiences of pregnancy and share what's been happening.  

Here's a quick overview of weeks 1-12 (I know gestational counting is a bit confusing, but I am counting day 0 as the first day of my last menstrual period because that's what doctor's do.  Later I'll just start saying what week I'm in - so 12 weeks will mean that I have fully finished 12 weeks gestation and am sometime between 12 and 13 weeks):

• 0-1 weeks pregnant - Finally completed the requirements for my PhD!!!  Wouldn't it be crazy if this was the month DH and I were successful at TTC?  I wonder when I'll ovulate this month...

• 1-2 weeks pregnant - What an unexpected surprise - I ovulated on time (early even)!  I guess I'll be thankful to Thanksgiving for speeding up my cycle.

• 2-3 weeks pregnant - I literally JUST finished my degree (seriously, I don't even have the diploma to prove it), do I really need to start working full time already?

• 3-4 weeks pregnant - No way?!  Positive pregnancy test at 8dpo?  I can't believe it!  Hoping the third time is the charm.  It's been 3 months since my last chemical pregnancy.  Thanks to a standing appointment at my doctor's office, I get a positive blood test at 10dpo (HCG = 40).  Progesterone looking good too (hopefully the supplements will help).

• 4-5 weeks pregnant - Still not feeling very pregnant, but the tests are actually getting darker this time and no sign of dropping temperatures.  Follow-up HCG test at 16dpo = almost 800. 

• 5-6 weeks pregnant - Christmas time!  Have a confirmatory OB appointment this week - pelvic exam looks fine, HCG up to almost 10,000, progesterone levels still holding.  Disappointing, though, because I was told I'd get my dating ultrasound at this appointment.  Oh well, I'll have it soon and we should be able to see more (maybe even the heartbeat!).  Glad I can spend the time with loved ones and still feel good eating whatever I want.  Sadly, nausea starts to kick in at the very end of this week. 

• 6-7 weeks pregnant - So nauseated, ugh, and getting worse!  Everything sounds gross to eat, but if I don't eat I feel worse.  Smells are overpowering.  DH, mom, and lil sis all come with me to my dating ultrasound at the end of this week (I keep a barf bag with me during, just in case).  There we can clearly see one little bean with a tiny heartbeat!  Baby is supposed to be the size of a cranberry now.  His or heart is beating away at 126 bpm, measuring about half a centimeter crown to rump.  Ultrasound dating puts me at 6 weeks, 3 days.  At the end of this week, I break down and ask for a prescription for nausea medicine (so far still no vomiting, despite some close calls).  Doctor's office prescribes Zofran.  There are, of course, shenanigans with insurance that delay me getting my medicine.  Even then I can only get 12 pills!  Sunday morning, I take the smallest possible dose (cutting one 4mg pill in half) and head off to church.  The nausea relief seems to last full on for 2-3 hours, then I feel a bit yucky.  But overall the day is much better than the previous.

• 7-8 weeks pregnant - I continue with a daily dose of 2mg of Zofran, which seems to definitely take the edge off of my nausea.  Some days it's still fairly unpleasant in the evening, and I still hide out in bed as much as possible (reclining and staying away from the smells of the main house seems to settle my stomach).  By this point, DH is doing all the household chores and shopping (sorry, honey!).  Our dog barely sees my face and misses his usual pets and attention.  I am very grateful this week that I'm not doing this on my own.  At the end of the week, I have a sudden reprieve from nausea and actually feel well on Sunday when I go with Lil Sis to the first practice of the adult choir I'm joining with her.  Sadly, the nausea is replaced by very intense constipation (not that things have been moving that well the past 2-3 weeks either).  Sunday evening is occupied with a trip to get some emergency stool softener (Colace) and then several unpleasant sessions on the potty.  By bedtime, the toilet is clogged and I feel a bit better, although I still sense a backlog.  Oh, the indignities of pregnancy.  The next day will require DH to shop for a better plunger :(

• 8-9 weeks pregnant - Things on the nausea and digestion front are mostly unchanged.  I keep up with my Zofran and Colace regimen and some days are better than others.  I thank my lucky stars that working from home is an option for me a couple days a week.  If I had to put on real clothes and sit at my desk every day of the week, I don't think I'd make it.  Toward the end of this week, I receive a surprise gift in the mail - a fetal heart doppler!  Naturally, I set to work right away trying to find the baby's heartbeat and at 8w3d I am able to find it after several minutes of searching.  What a joy and relief <3  It is too faint to pick up the exact rate, but I estimate that baby's heart is now beating about 160bpm.  The nausea has been a comforting sign, but it's so nice to have some additional evidence that everything is okay with the little one.  Given the unknowns about doppler safety (although they are most likely perfectly safe), DH and I decide to limit use of our home doppler to once a week for no more than 5 minutes.  Baby is now supposed to be the size of a raspberry.  

• 9-10 weeks pregnant - Nausea continues, but otherwise nothing interesting going on this week.  For a few days I think maybe the nausea is ebbing, but then toward the end of the week it hits again full force and I end up doubling my Zofran dose (2mg twice a day instead of once).  DH and I begin to evaluate the room that will become the nursery and actually clean it up a bit. 

• 10-11 weeks pregnant - I have my first real prenatal appointment this week.  Other than thinking I might throw up in the waiting room (still no actual vomiting to this point, fingers crossed), the visit goes well.  The midwife takes a good 20 minutes to answer all my questions and uses the office fetal doppler.  She finds the heartbeat quickly and measures it at 170bpm.  Still signs of just one baby.  So far I haven't gained any weight (but seems I've about regained any I lost earlier).  Hoping to continue healthy gain throughout pregnancy.  Also, blood tests reveal no concern about anemia, which is a relief.  Looks like I can continue my gummy vitamins until I feel better (which I really hope will be soon). 

• 11-12 weeks pregnant - Nausea is still going strong, but constipation is much improved by this point.  I am able to eat a variety of things now, many of which resemble healthy choices (except the Girl Scout Cookies that just came available this week!).  Still some aversions, of course, with meat being a big one (luckily I can still get my protein in by hiding it in sauces).  I don't think I'm showing yet, but I keep thinking maybe my belly is pooching a bit more than normal.  But maybe it's just my imagination.  Either way, I'm glad it's winter and I'm relying on loose pants and big sweaters to get me through.  I plan to start taking bump pictures next week so I can have a basis for comparison week to week.  Evidently baby is now the size of a lime and looks a lot like a full-sized baby. 

Please share your first trimester experiences in the comments below.  What symptoms did you have and when?  What were your must-have maternity items?  

Countdown to TTC: Week 38

Calculate the Costs

As a result of the holidays and various other obligation, I am getting behind on writing up my "weekly" posts, but I have been working toward my goals and trying to remember everything I experience so I can eventually write up my backlog of activities.  A few weeks ago, I decided it was time to think seriously about medical expenses of a future pregnancy.  As we enter the new calendar year (the year in which I sincerely hope I will be able to conceive my first child), I intend to begin experimenting with prenatal vitamins and other supplements I want to take to have a healthy conception and pregnancy.  But diving into this more medical aspect of the process made me curious about the actual costs of pregnancy and childbirth.

Of course, there are perhaps more unknowns than knowns in this arena (Will I be able to have the vaginal birth I desire? Will I experience any pregnancy complications? Will my health insurance coverage change before I become pregnant?), but I decided the responsible thing to do would be to research what the costs might be for my current health insurance provider given some reasonable assumptions.  In addition, I was interested in figuring out what my maximum possible out-of-pocket expense would be given my current insurance situation.  Although I wouldn't be willing to place any bets on the accuracy of these calculations, they should give me an idea of what I should be aiming to save over the next several months.

Step 1:  I began my calculations by going onto my insurance provider's online member site and using their cost estimator tool (a nice service if you have access to it).  I asked for an estimate of the total medical costs associated with a pregnancy and vaginal hospital delivery in my geographic area (see below for the output).  The results I got were a bit confusing, but it seems to me that the numbers given for each expense category were total expected billings (not amount owed out of pocket, as I would have expected). 

Step 2:  Once I learned what the expected total billings would be for this type of pregnancy and birth, I had to consult my health plan's summary of benefits to determine what proportion I might be expected to pay of these total expenses.  My medical deductible and pharmacy deductibles are $250 and $100.  Once those are met, my plan expects me to pay the following for prenatal care and delivery costs:

Step 3:  Now that I had figured out the expected costs (assuming a vaginal delivery and a pregnancy that was not high risk) and what proportion I would probably have to pay, I could make some estimates.  I began by evaluating the maximum possible costs.  Knowing my deductibles and the additional out-of-pocket maximum for my plan, I determined that $2350 was the absolute most I would have to pay for a pregnancy that spanned only one policy year (I could of course be unlucky and accrue some high prenatal costs in one policy year and then some additional high costs for labor and delivery in the next policy year when new deductibles and out-of-pocket maximum would apply).  So, worst case scenario has me paying as much as $4700 for one pregnancy. 

Step 4:  Finally, I wanted to estimate the real expected out-of-pocket cost of the standard vaginal delivery pregnancy the cost estimator summarized for me.  Assuming a $200 copay for the delivery facility (even though the cost estimator predicted no charge for this actually), plus 20% coinsurance on all the medical tests and doctor's bills (although some portion of this would no doubt constitute no-charge prenatal care), and the full estimated amount for pharmacy, I came up with an expected total cost of $1836.  It would also be reasonable to predict an amount a few hundred less than this if much of my doctor's costs came from fully covered prenatal care and if my birth hospital did not charge a facility fee.  On the other hand, any sort of complications or need for additional tests or specialized care would quickly bring this up to the maximum possible cost. 

So, in summary, I learned that I should probably expect to spend a couple thousand dollars on my birth.  Even if I switch insurance plans (which I actually expect to do), I will most likely select one that has a similar deductible and out-of-pocket maximum.  I also realized that small changes in my assumptions can make a substantial difference in how much I would overall expect to pay for a single pregnancy and birth.  This could be a scary realization, but I think my response to the information is reasonable.  I will make tentative plans based on what is most likely to happen, but I will also be prepared for things not to go according to plan.  Probably a good approach to new parenthood as well, now that I think of it...

What about you?  Do you or did you know down to the dollar how much your pregnancy should cost?  Have you come by any useful information about paying for pregnancy and childbirth or tips for dealing with health insurance providers?  What are some top dos and don'ts when it comes to pregnancy-related medical expenses? 

For more in this countdown series, see last week's challenge about Eating right while eating out.

Countdown to TTC: Week 44

Planning with Pinterest!

  

The past couple of weeks have been extremely busy for me, so this past week I decided to tackle a goal that was more fun than challenging.  I started a secret Pinterest board to keep track of all of my baby-related findings.  In addition to my public Pinterest account, I wanted a page where I could keep track of my personal baby research, like links to pages of nurse midwives in my area, hospitals where I could give birth, or play groups in cities I might live in when I have little ones.  I decided to keep it private because (1) my level of obsession with this topic is a bit embarrassing given that I'm not even TTC yet, and (2) I once posted a few baby-related pins in a row on my public page and was instantly being interrogated by my social network.  As much as I enjoy sharing this weekly journey with you, I don't want my family and friends to be confused about my status. 

Secret or not, I love spending my free time researching these kinds of topics and imagining what the future might hold, but often I forget what I discovered as soon as I close all the tabs on my web browser and then I end up looking the same things up all over again (or, even worse, forgetting about a gem that I found).  But surely that is the purpose of a site like Pinterest?  Even though I keep lots of tabs open on my computer, I can never have every page I am interested in easily accessible until the time when I need it.  Invariably the moment I give up and close that recipe I had open for two weeks is the time I finally have a chance to try it.  And planning for a pregnancy that's at least 10 months in the future, I really need to be able to store up the information I find for a later date.  I have also created a Word document to track some information, like my thoughts and ideas, and a folder where I can store published research articles about topics like childbirth, since unfortunately those types of materials rarely have any pictures and as a result Pinterest won't even let me store them.  

Ultimately, this week's goal wasn't so much of a challenge as an opportunity to acknowledge that TTC is really approaching.  It's important to get my mind and body in a good place, but I also need to keep the end goal in mind and maintain my motivation to make positive changes in my life.  The day DH and I decided to start trying is now less than 300 days away!  Until then, I want to continue to enjoy this time of anticipation and preparation.  Different people have their own ways of savoring the moment, but for me one of the keys is getting to imagine and mull over every detail, even if it's just a private activity on my secret Pinterest board.   

What about you?  What's your favorite way to stay motivated to get healthy and prepared, or just to keep up your excitement for a pregnancy or baby that's still a long way away?  Do you keep a secret Pinterest board or is your baby mania out there for all to see?  

For more in this countdown series, see last week's challenge about Proper Posture.