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

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

Our situation: we went through a highly professional midwifery associated with our local hospital system. It was sort of the best of both worlds: the midwives led the birthing process but the birth was in the hospital, which was reassuring. In case something went wrong, there was lots of doctors and technology on hand. Since we were first time parents aiming for a non-medicated birth, that combination really took a lot of pressure and stress off.   
When we got our scans indicating a marginal cord insertion, the doctor said it wasn’t anything to be nervous about, and they’d just keep an eye on things. The midwives said the same thing. Thus, we had multiple scans done along the way leading up to birth, and none showed anything concerning — plus all of our baby’s vitals and growth rates were normal. Our medical team did say that if we’d had a velamentous cord insertion, that would have been a different story and a c-section would have been recommended at 40 weeks. 
My wife gave birth at the end of the 40th week. After birth, it turned out we did actually have a velamentous cord insertion which made our pregnancy and birth quite high risk. Knowing this up front would have made us nervous wrecks throughout the pregnancy and we were extremely fortunate to have everything turn out great. Baby is happy and healthy – a little too healthy since he seems to be a giant in the 90th + percentile in size. 
So our advice: a marginal cord insertion isn’t something to make yourself anxious about, BUT you never know if the scans are telling the full story and if there might be something more concerning to be aware of. Don’t be too stressed (that’s not good for you and there’s nothing you can do to “fix” it), but take precautions like having your birth in a hospital if at all possible. Ideally, you can still do that with your midwife or doula leading the charge, if that’s something you want to do. 

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!

Week 23 pregnancy bump. Duck sitting on human baby bump.

Jackson resting on my bump.

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.

Week 23 pregnancy bump

Yay! I finally have a bump! Not only is my 23 week bump much larger than my 10 week one, but you can really see the significant arching in my back. Ouch!

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.  

More parenting articles you’ll love:

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  • Reply
    Hope Haskins
    February 22, 2021 at 11:13 pm

    Thank you all for sharing about the marginal insertion. We just found out that we have that going in and it’s nice to have a personal story…

    • Reply
      Aaron von Frank
      February 23, 2021 at 8:09 am

      Glad to know sharing our experience with a marginal cord insertion was helpful, Hope! Wishing you and your family all the best moving forward in your pregnancy.

  • Reply
    MJ&Sean Smith
    September 12, 2019 at 7:20 pm

    I have to admit – I am a bit jealous of the midwife option you have! We have a “remote access hospital” and the closest midwife group is an hour away (55 miles). From what I understand, good outcomes for birth decline the further one has to travel to give birth. So, I’ve been considering a doula (the one doula that exists within an hour radius) for extra support. I love my doctor, but I learned recently that she won’t necessarily be available for the delivery. Times like this I miss the options that urban areas/cities have to offer! AND I feel you with the back pain! I go to bed with a dose of acetaminophen and an ice pack most nights. How is the KT tape working for you? Is everything feeling incredibly effort-ful now? Once I hit week 26 I suddenly felt like everything was SO difficult. My normal yoga class now feels like I’m training for some sort of extreme marathon. Thank you for sharing your updates and research! Glad to here Gator Steve (lol) is feisty and doing well. It’s nice to read along with someone who is due at the same time!

  • Reply
    Cecile Arquette
    August 17, 2019 at 2:42 pm

    You are doing all the right things: getting good care, reading to the little guy, exercising, eating well…enjoy it, you’ve got this! After all, you already know how to diaper ducks 🙂

    • Reply
      Aaron von Frank
      August 17, 2019 at 6:16 pm

      Thanks, Cecile! We figure if we can diaper ducks, raising a child should be a piece of cake. 😛

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