Hello Friends! This has been quite the crazy week for me. Oddly there hasn’t been one big thing in particular, but a lot of smaller things that have just been eating up my time (and energy). Between the long weekend, doctors appointments, trying to get my baby shower thank you notes out the door, and running low on steam (hello 8th month of pregnancy), this week has really knocked me on my butt!

So instead of my usual three posts this week, it will just be this one. But trust me, it’s a good one!

If you’re considered a high risk pregnancy then you’re OB will most likely want you to come in twice a week for a Nonstress Test (NST)  starting at 32 weeks. We opted out of the twice weekly NST and chose to do the once weekly BioPhysical Profile (BPP). We figured it’s less exposure, not as invasive, takes far less time, it gives the doctor more information, and although it costs more we are hitting our deductible in July with the birth of the baby.

Here’s what you can expect at your weekly BPP appointment.

What to Expect at a BPP

Setting up your appointment.

Depending on how your OB office works, you may or may not need to set up two appointments. One with the ultrasound tech and another with your OB immediately after to go over the results.

At my OB’s office they separate the appointments. I have my first appointment set up with an ultrasound tech, then 45min later I have my second appointment with my OB to go over the results.

Sometimes the BPP’s take 5 minutes and other times they can take up to 30 minutes (if baby is sleeping), so bring a book or something to do in case you have a decent amount of waiting time between the two.

Moments before your appointment.

This ultrasound is not like those early ultrasounds where it helps to have a full bladder. No no. At 32 weeks your baby is fighting for room in that itty-bitty-living-space and will probably be more active if you pee before hand and give him a little more room to move around in.

It’s not as important for baby to be awake for their BPP as it would be in a NST (since NST is solely watching heart rate patterns for movement), but it certainly helps it move along.

I like to give my little man a pep-talk on the car ride over. I rub my belly and tell him that the more he cooperates the faster it will be over. This always seems to wake him up.

If talking to your little one or rubbing your belly doesn’t work to wake baby up, sometimes I give little taps on my belly, or sing on the car ride over. Baby can’t resist dancing when we’re singing along. Another tip to wake baby up is to take the stairs, instead of the elevator. The action of moving then resting usually is enough to wake them up.

During the BPP Ultrasound appointment.

Once you lay down on that table and they squirt the scalding hot jelly on your belly, you BPP ultrasound is just like any other ultrasound. Depending on what your OB puts in your BPP orders they may just do a partial BPP and call it a day, or they may do a full BPP with growth measurements. My OB likes to alternate by doing a full BPP and a growth scan one week, then the next week it’s just a partial BPP.

The difference in time between the down and dirty BPP  vs the in-depth BPP with growth scan is maybe 1 minute. And overall, if baby is awake, the whole scan takes less than 5 minutes.

The ultrasound tech may or may not comment on what she sees, “Baby is doing great!” or “perfect fluid levels!”. But don’t be discouraged if she doesn’t say anything. Technically it’s not her job to give you the results and she may not feel comfortable doing so. That’s what your appointment with your OB after is for.

You may even get a picture to take home with you. Check out that bone structure 😉

Going over Your Results with Your OB

After your BPP ultrasound you may go back into the waiting room for a bit. Once the nurse calls you back in she will most likely run you through the routine appointment exams… taking your weight and blood pressure and having you pee in a cup.

She’ll leave and your OB will come in and go over your BPP scores with you.

What the BPP Scores Mean

I’ve found that most practices will score baby on a 0-2 scale for each biomarker (amniotic fluid volume, movement, heart rate, and breathing). Making an 8/8 a perfect sore.

Don’t be upset or worried if baby doesn’t score well on breathing. This is the hardest of the tests to catch since babies don’t practice breathing continually. Catching it in the small window that you’re there can be tricky and most OB’s know that and aren’t worried about catching it every time.

My first BPP was so easy because baby was awake and active. My second BPP lasted a lot longer… we were able to catch & score all the biomarkers (except breathing) within the first 5 minutes, but then spent another 15 minutes trying to catch a glimpse of him breathing.  So instead of doing another scan, since baby was clearly in a sleep cycle, I told them that I’d give them a call later in the day after I felt him hiccuping (since that is considered practicing breathing). They liked this compromise and I agreed that if I felt no hiccups after 1-2 days I’d come back into the office for another test.

Final Tips/ Words of Advice

Chocolate is a great way to get baby moving and my chocolate avocado brownie recipe does just the trick!

Also, try to schedule your BPP’s for the time of day that baby is most active. My little nugget likes to sleep-in in the mornings but is doing somersaults and back flips by the afternoon, which is why all but one of my eight BPP’s are scheduled for the afternoon.

Interested in seeing more of my pregnancy with type 1 diabetes journey? I’ve organized all my pregnancy with T1D posts here.

Question of The Day

What was your experience with BPP’s and NST like?