Prior to yesterday, we hadn't had many medical updates about Sophie. The Lord has been good to us through this journey. We have been supported by so many friends, family members, friends of family, our church, and through a few different organizations. We have received some amazing books and resources.

Each week, God has taught me something new about Him. Each week, He has had me surrender a part of myself that I didn't know needed to be surrendered to Him. He has taught me what it is like to truly let Him carry me through this devastation. To trust in Him and in His plan. To not need understanding. To let His plan unfold in His timing, and having peace in not knowing His timeline. To have peace that our daughter will dwell in His home and not our own. To understand that our lives will never be complete here and we will never find satisfaction in things of this world, so to always have our eyes set on things above. To be thankful for our health.

Yesterday, I had two appointments. The first appointment with my "regular" Maternal Fetal Medicine doctor at EVMS went well and there were no significant updates. The second appointment at Norfolk EVMS with an ultrasound and Pediatric Cardiologist did not go so well. The medical team was phenomenal, we just did not get news we were hoping for. 

1. We know that the umbilical artery is failing. This is Sophie's lifeline and the only thing allowing her to survive in utero. Be patient with me while I try to translate my understanding of what is happening. It is probably pretty far off from the medical lingo, but I am trying my best. There are 4 stages of failure that describe the amount of blood and oxygen that pass through the umbilical cord to baby (in the medical world this is called doppler velocimetry) - 1) Normal Flow, 2) Decreased Flow, 3) Absent Flow, 4) Reversed Flow. When we originally received the diagnosis, we knew that the umbilical artery was in Phase 2 of failure. We are now in Phase 3 (Absent Flow) and there is no real timeline of when Stage 4 (reversed flow) kicks in. Stage 4 would mean end of life for Sophie. With this news, we were given two options.

• Option A: I could be sent to the hospital for continuous monitoring to see when the umbilical artery switches from Stage 3 to 4. This could be days to weeks. When I get to Stage 4, they would do an immediate vertical C-Section. This would be the only real chance of a live birth, but this would be extremely hard on my body physically and would make future pregnancies risky. I had a horizontal cesarean with Luke, so having a vertical cesarean would be far from ideal.  
• Option B: We can let nature take its course. This means at some point over the next days to weeks, I will move from Stage 3 to 4 and Sophie will pass comfortably in the womb. Once she passes, I will be induced. This is the route we are going and sadly it means it is very unlikely that we will not get to meet our baby girl alive. A big reason for us going with this option is due to the 2nd big piece of news received yesterday from the Pediatric cardiologist. The OBGYN agreed that I was making a wise decision for both Sophie and I. 

2. We know Sophie's heart defects are not compatible with life outside of the womb. The Pediatric Cardiologist was so kind and was extremely thorough in studying Sophie's heart. Again, this is just me breaking down my understanding of her heart defects. Hearts are supposed to have 4 chambers. Sophie's has 3. The typical anatomy of a heart has a right side with an atrium and ventricle that feeds the lungs. The left side also has an atrium and ventricle that feeds your body/blood. Sophie's right and left ventricles are combined meaning her two different types of blood are getting mixed. Along with this, her pulmonary artery that sends blood to her lungs is not connected to her heart. It is there, it's just not connected to the heart like it should be. He drew me a picture and did a really good job explaining it to me which I have attached to this post. This means if she were to make it through delivery, she truly cannot survive on earth but for maybe a few moments. He did say that he has done surgeries to try and fix these heart issues on a Trisomy 18 baby in the past, but graciously explained with Sophie's many other monumental abnormalities, she would not be a good candidate. There is no fix he can provide. I let him know that her quality of life is more important than the quantity of her days and we would not be interested in the heart surgery. He agreed that we were making a good decision. 

All of this reduces our hope of having a live birth. There is no real timeline for when things happen, but they believe things will progress quickly and there is little hope of me making it full term. As devastated as we are to not get to meet our baby girl alive, we have so much peace knowing she will have healing in heaven and we will get to meet her in her restored body one day. Yesterday on the ultrasound we could see her sweet face and she looked so much like our Luke. She has a beautiful face and beautiful hands, but my heart aches looking at her very broken body. It is painful to not fight to meet her alive, but we also want her to be able to peacefully pass in the womb, the only home she knows. 

Today, my heart feels like it's the one that needs a surgeon. We know that no matter what happens, God is always good. We are thankful for every moment that we have with Sophie and are so blessed that God chose us as her parents. That He trusted us with her life. Today, I come to Him with my broken heart and plea that He will rescue our daughter and that He will give us reminders that He is with us and He is weeping with us. We will continue to lean into Him and trust in His plan. Today my prayer request is that Troy and I can find peace in waiting for His plan to unfold and that He will give us endurance through this suffering. 

Here are a few resources from the past few weeks:

• This is a children's book that explains that even through hard times, God is always good - The Moon Is Always Round
• Angie Smith also carried a child with a life-limiting diagnosis. She wrote a book about her experience and her testimony. It can be found here - I Will Carry You
• A one year devotional on Hope - One Year Book of Hope
• The playlist we have been adding songs to through this journey - Sophie's Playlist
• I also linked our song for the week on YouTube, Lead Me to the Rock.