My Little One seems quite content where she is. In fact, rather than descend into my pelvis (as is usual for first pregnancies), she moved upward. All that activity the other night took her in the opposite direction. However, she is still head down, and that’s good.

Now maybe this is TMI, but the internal exam shows again, for the third week, no change in the cervix. It is not “ripening” (softening and becoming thinner), and I am not dilating.

These two factors — baby being far up in my belly and a not-ready cervix — existing ten days before my due date prompted my doctor to do an ultrasound just to see what’s up.

Yippee! (Not sarcasm.) I’ve longed to have another look at her, but third trimester ultrasounds are only done when there is a concern or anomaly. So in this case I’m happy to be an anomaly. Little One is in good shape. She has a beautiful heartbeat, and I also got to watch her breathing — her diaphragm was moving. I wasn’t worried about a cleft lip, and it turns out she has not got one. (This is something earlier ultrasounds don’t usually catch and genetic testing doesn’t cover. Cleft lip/palate is surgically remedied, but it’s nice to know that it’s not an issue.)

The doctor measured her and estimated her weight at approximately (and this might be quite off-base) 7 pounds, 11 ounces. If that’s correct, she’s a little bigger than I hoped for. I know that’s an average weight. I was hoping for between 6 and 7 pounds (the smaller the baby, the easier the birth). The longer she takes to arrive, the more weight she might gain, which could make it harder to deliver vaginally.

In conclusion, Little One is well. There’s plenty of amniotic fluid. She is not in distress. Next week we’ll see if there has been change. It could happen. If not, then we need to consider our options over the next 10 to 17 days.

1. We can wait about a week beyond the due date and see if labor starts naturally.
2. At 41 weeks, if my cervix is ripe and she’s dropped, we could induce and probably be successful.
3. At 41 weeks, if my cervix has not changed and she has not dropped, an induction is unlikely to be successful. It also means natural labor might not succeed. Which means we’d consider a planned C-section.

One thing for certain is that my doctor said Little One will be born by September 10th one way or another.

I told the doctor that if conditions are such that an induction would be likely to fail and require an unplanned C-section in the end, then I’m leaning toward a planned C-section. Recovering from major surgery is, well, major work; recovering from 20 hours of labor plus a C-section sounds worse. I would rather have the energy available to care for my child.

Today when I thought about the possibility of a Cesarean, I felt a little sad. As I’ve said before, I don’t have a fantasy of the “perfect birth experience.” I just want to be alive and have a live healthy baby. I think the real issue underneath the sadness is some fear — of the surgery, risks, pain, the Unknown. And yes, there is some sadness at the thought that I might not experience the process of labor; I’m curious about it. Every choice we make means other options are not experienced, and there’s a bit of grief in that. I told my doctor, and she was empathetic. There’s still time, and I’m sitting with Not Knowing. She’s a strange companion.

However this plays out, I’m grateful to live in an era and a country where there are helpful options to consider. Somewhere in the world, a woman dies every minute from pregnancy and labor complications. In Afghanistan, it’s estimated that one woman dies out of every seven women who give birth — currently the highest maternal death rate in the world. While I cannot rectify this, I can be grateful for what I have. And I am.

Well. Yesterday Husband and I showed up for our 3:00 p.m. appointment only to be told the Baby Doc had just been called out to deliver. I remained calm, standing there with my little brown bag containing my urine sample, sweat dripping down my face. The walk from the car to the office took what felt like supreme effort. The receptionist re-booked me for 9:30 a.m. today with apologies. I thanked her and left.

As soon as we got out of earshot, Husband asked if I was angry. And I said no, then began to boo-hoo. Good lord. We sat in the cool lobby in a private corner while I silently sobbed. He asked what was wrong, and I said I didn’t know. It’s just hormones. A minor hiccup in the day and an easy reason to flush a few tears. After about ten minutes I pulled myself together; Husband returned to work and I decided to run errands close by, since we’d be returning to that same building at 6:00 p.m. for our second childbirth preparation class.

Perhaps the tears came so easily because this schedule interruption is just one more reminder of all the things that are beyond my control at a time when I feel so much is already beyond me. Except for exerting control over my own actions and thoughts, I know that having control over everything is an illusion, and it’s part of my practice to release the impulse and desire for control.

Yet it does add up: my body is following a process of its own, my fingers and feet are puffy sausages, my knee sporadically complains, the weather is what it is, building projects happen according to other people’s planning, traffic is unpredictable. I worry I’m not gaining enough weight for my child (only 11 pounds so far). I don’t know what my baby looks like or if she has all her essential pieces. I don’t know what labor will feel like. I don’t know what kind of birth experience I will have. I don’t know how to care for and raise a being who is absolutely needy and dependent on me. I don’t know what events await my child, my husband, myself in our future. I don’t know how we will be affected by the larger political and climate changes occurring now. And I have a weird red spot on my right breast.

So the cancellation, while a small glitch, was the proverbial straw. Boo-hoo.

It turns out that indeed I have not gained any weight in the past two weeks. This is the time during pregnancy that the baby is supposed to be accumulating fat stores and when women are supposed to gain the majority of their weight. I’m eating as usual. The doctor said it’s okay, however. As long as I don’t feel hungry all the time and as long as I don’t lose weight, she says most likely the baby is just taking from my own reserves. Everything else is dandy: blood pressure 105/60, no sugar, good baby heartbeat, good fundal height. Relief.

I did show her the red patch on my right breast. It’s been there for a couple months in the one o’clock position. It doesn’t hurt; there is no lump. This breast has a history, which is why it raised concern. Back in 2000, for reasons no one could ever determine, I had mastitis in that breast. It tripled in size, was painful and hot, and I had a fever of 103 degrees. I actually went to the ER because I was so miserable and the onset came in the late evening. (I cannot believe mothers still nurse while having mastitis, but they do.) The other notable is that in 2003 the same breast had a couple of cysts that were biopsied and rated as benign. The doctor measured the spot at 9 x 5 centimeters and said, “Hmmm, very interesting.” She palpated the breast and found no lumps. She made a note in my chart and said that it’s possible I could get mastitis again while breastfeeding. We’ll see.

And that’s the latest on the baby front.