Pregnancy update, Week 23: Marginal cord insertion, back pain, and more

Last Updated on January 3, 2022 by Aaron von Frank

We wanted to provide a 23 week pregnancy update to let people know how things are going and also (hopefully) provide some helpful information for other expectant parents out there. In this update, we cover:

• Marginal cord insertion 
• Midwifery and centering
• Genetic and chromosomal testing
• First baby bumps and kicks 
• Pregnant mamma back pain
• Nightly reading to baby in the womb 

1. Marginal cord insertion

When we were getting our Week 21 ultrasound, our OB went through all the numbers and said everything was looking good. At the very end of the appointment, she casually mentioned that we had a “marginal cord insertion” (not to be confused with a velamentous cord insertion). 

A slight look of panic swept over Aaron’s face… 

A marginal cord insertion simply means the umbilical cord is attached off-center on the placenta, and that the baby might not be getting the full benefit of nutrients the placenta has to offer. In extreme cases, this can be a problem since it means less nutrition goes to the baby, causing a host of complications.

Increased monitoring and time will tell if there’s a problem. If Gator’s weight gain starts to plateau or is below normal, that could mean he’s not getting the nutrition he needs. 

Our midwives see this a fair amount (it happens in ~7% of pregnancies), and said they wouldn’t even worry about it at this point, which is pretty much the same stance the high-risk OB took. All it means for us right now is that we have to have a few extra ultrasounds — which has the added bonus of a few extra opportunities to see our little one!

*Feb 2021 update: someone emailed us with the following experience and question:

“My wife and I just came back from our 21 week ultrasound and found out we’re in the same boat. We’re going to for a specialist ultrasound in a week to get a better look.

I’m wondering how that progressed for you during your pregnancy and if you had any advice or guidance. Surely you’re not doctors and we will seek out licensed medical advice as well,  but just wanted to hear the story from another parent.”

Our response: 

We know it’s a bit unnerving getting the marginal cord insertion news. As you said, we’re not medical specialists, but we’re happy to share our story and advice. 

2. Midwifery and Centering

What is a midwife? Please read this article and this 2018 study to learn more about what midwives do and how they improve pregnancy outcome for mothers and babies, both in the US and abroad. 

We’ve signed on with Greenville Midwifery Care since we’re aiming to have a natural childbirth, assuming all goes well. Midwives are par for the course in many European countries, but less frequently used in the US.

One great feature of Greenville Midwifery Care is that they’re part of our hospital system (Prisma Health), so we’ll be giving birth in the hospital should any complications occur during birth. 

Another great feature of our midwifery group is their “Centering” care group. Other parents that are expecting around the same time we are meet monthly along with dedicated midwives to discuss and plan for all things related to pregnancy, childbirth, and parenting. During these group meetings, you really get to know your midwife team and they really get to know you. Plus, many moms/couples end up staying in touch once they given birth and their kids end up being friends & playing together.

Since only a few other couples we’re friends with have children close to our son’s age (ironically, one of them is also in our Centering group) it’ll be really nice for us to have that on-going support system. 

Centering has been incredibly helpful: it’s like having a village of support around you!  

3. All testing done!  

There is a LOT that can go wrong in pregnancy, which is why most moms/parents wait until pretty far down the road to publicly announce that they’re pregnant. In case you’re uninitiated, here’s a taste of some of the risks and testing that are done at specific points during a pregnancy:

• Genetic and chromosomal abnormality testing | Weeks 10-15 – The rates of having a baby with Down syndrome at term jump from 1 in 1,340 at age 25 to 1 in 85 at age 40. As part of our non-invasive prenatal testing (NIPT), our baby was tested for other genetic and chromosomal abnormalities (such as trisomy 21) as well. 
• Genetic screening | Week 15 – We had an early scare with our more advanced genetic screening at around week 15, when I found out I was a carrier for a certain type of muscular dystrophy. Thankfully, Aaron’s genetic tests came back negative, so that’s not a risk factor for our family.
• Spina bifida | Weeks 15-20 – In June, we were at the point in our pregnancy where Spina bifida testing could be done. (This is a neural tube defect that causes the spine or spinal cord to form improperly.) 

There are a host of other increased risks associated with our advanced maternal and paternal ages as well, including: gestational diabetes (testing for that happens next month), placenta previa, postpartum hemorrhage, low birth weight, high birth weight, and more which we won’t find out about until way down the road. Yikes! 

Thankfully, Gator Steve (our temporary joke name for our son) has been tested and is doing great. In about 40 years, we may finally stop being concerned about how he’s doing. Doubtful though.

4. Baby bump and baby kicks! 

I’m happy that my “baby bump” is finally showing!

I felt like a whale at week 10, but looking back at pictures, I was barely showing. Since pre-pregnant me has always been pretty lean, all of my pants & shorts stopped fitting almost immediately after we found out (when symptoms started occurring), once those hormones kicked in and I started storing more body fat. 

Now I have a cute little baby bump (instead of looking like I had a few too many plates of nachos for lunch)! It’s quite obvious that there is another creature forming inside me, which means maternity clothing and polite questions from other moms when I’m out in public. 

On July 20th (~Week 21), Gator gave me his first noticeable kick. A few moments later he gave his dad a nice firm kick too. Kicks grow stronger and more frequent by the day. Jackson the Duck has even gotten to feel them when she sits on my lap at night!

5. Back pain

When you’re pregnant, you feel like you’re completely out of control of your body. Each week and trimester seems to bring a new set of aches, pains, and other pregnancy symptoms. 

As my stomach increasingly imitates a beach ball, it’s putting a lot of strain on my lower back (spine, muscles, and tendons). The pain is pretty awful and makes it very difficult to ever feel comfortable while working or trying to sleep. Unfortunately, this is one of those pregnancy symptoms that doesn’t go away and will only get worse (until post-birth). 

Pregnancy yoga + moderate exercise + husband back massages do help though!  I’ve also just ordered some KT tape to support my lower back & belly, so I’m hoping that will make a big difference during my day-to-day.

6. Nightly reading

Gator can hear now! He’s probably been able to hear since around Week 18, but he can supposedly begin to recognize our voices now.

We’ve been reading to him every night before bed. I’ll read one page, then Aaron will read the next. Occasionally, we’ll get a kick in response, which we interpret as approval. 

What about the notion of continuously blasting classical music and other noises into my uterus to create a “baby Einstein”? Medical experts say not only is this methodology unfounded, but it may even be detrimental to fetal development since it can disrupt their sleep cycle. (Developing little humans sleep about 14 hours per day – almost as much as Bob von Kitten!) 

As our pregnancy app, What to Expect, details:

“Some experts even worry that it [playing classical music in utero] can be harmful if it signals the beginning of a very premature pushy-parent, which places too much emphasis on achievement at a too-early age. Babyhood (including fetushood) and childhood should be a time of simple pleasures, they say. There’s also the theoretical risk that parents may unwittingly disrupt the natural sleep patterns of their fetus as they attempt to turn the womb into a classroom — actually hampering development instead of nurturing it.” 

We don’t plan to be pushy helicopter parents, so I’m keeping things nice and quiet in my uterus. Gator will have plenty of stimulating noises to contend with while he’s awake in a few months. 

That’s it for now! 

Coming soon: our favorite pregnancy and parenting books thus far! We’ve been reading and learning a ton of interesting information and look forward to sharing our favorites with you.  

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