Thursday, June 19, 2008

41 weeks today and lots of good news

I recently got back from seeing Dr. Wonderful. It was a very reassuring visit. But that is starting somewhat in the middle. Let me backtrack a bit.

This morning my midwife called and suggested that I get in to see Dr. Wonderful before the weekend. As I mentioned in the previous post, we talked about when it was time to induce medically. I could feel the dragon breathing down my neck, but it was good to get it out in the open. Cathy thought it would be good to see my OB and talk with him about options just in case we need to make that decision this weekend so as not to surprise him. This time I asked her directly if she was being more conservative with me than she normally would be. She said that she was concerned the drugs from multiple IVF cycles might interfere with my body's ability to go into labor naturally. She was also concerned because of my anxiety levels. Whether she meant because she was afraid increased anxiety would equal increased adrenaline and therefor impede labor or she was concerned that I was picking up on something, I am not sure. Either way, I appreciated her concern and openness.

Then I called Stacey, my doula and close friend to tell her Cathy's thoughts. Stacey said, "You can have a hospital birth and still have a natural birth. Brad and I will be there to protect your space." If it was in a hospital it wouldn't be completely natural because I wouldn't be there if we weren't inducing or otherwise intervening, but she meant it could be as natural as possible. She suggested I put together a birth plan. I argued that if I ended up in the hospital, I would probably get some satisfaction out of being a really nasty patient (sorry any caring OB nurses out there). I imagine yelling, "Get the F out of my room!" or sarcastically saying, "Did I give you permission to come in here?" Actually, I don't think I would do that, but it is nice imagining it. I might still communicate they weren't welcome, but doubt I would be so obviously nasty. I would be subtly, but not too subtly nasty. I just don't like the way hospitals, nurses and doctors try to manipulate birth and thereby the mother. I also just might have a few unresolved issues with how poorly the nurses treated me when I was in the hospital with Ernest. The thought of getting even by proxy has a certain charm.

Eventually Stacey convinced me that the best thing for all parties involved (including her and Brad) would be to make sure everyone is on the same page. Alright, for Stacey, I can do that. If I need to. I still don't think I will. The important thing about this exchange and the one with my midwife moments before is that I realized I could survive a hospital birth if I needed to. I opened that door of acceptance just a crack.

This morning I headed of to see Dr. Wonderful with a new question added to my list: What would it look like to induce and what would be the possible outcomes.

The appointment couldn't have gone better. My blood pressure was up again, but no worse than usual, I was not spilling protein and I hadn't gained any weight. He is not concerned about PIH at this point. We did an ultrasound and saw that the baby had good movement (including movements that indicate normal mental development such as blinking and subtle lip and jaw movements), the fluid levels were good and the placenta looked good.

I asked him what the stats said about waiting. He said that after 42 weeks things start to look bad pretty quickly, there is heightened concern between 41 and 42 weeks, but he is fine with waiting as long as baby and fluid levels continue to be healthy. This was just what I wanted to hear. I felt like the dragon breathing down my neck disappeared. I have another whole week to let nature take it's course. I am convinced if I am still pregnant on Monday when I get rechecked, things will still look good. I have a good feeling LB will come on his/her own within the next week.

Just to be on the safe side, we talked about what it might look like if Monday things don't look good with the fluid levels.

Dr. W: If you were my patient, I would induce you that day.
Me: Well, I am your patient in many ways. How would you induce?
Dr. W: With Cervidil or Cytotec
Me: Can I do that as an outpatient?
Dr. W: No. They have done research in doing this on an outpatient basis and it is too dangerous.
Me: If the Cervidil or Cytotec get things going, can we continue without drugs.
Dr. W: Yes and that is a possibility. Sometimes, that is all it takes. Once the cervix has ripened, we may need to switch to pitocin. If you are on drugs you will need to be constantly monitored.
Me: Constantly?
Dr. W: Yes. They can cause placental abruption.
Me: What about the fact that constant fetal monitoring can cause a lot of unnecessary scares?
Dr. W: You mean false positives? I would rather deal with false positive than worry about missing an actual emergency.
Me: Sure, you might leave the room feeling ok after a false positive, but I am going to have heightened fear which could interfere with labor.
Dr. W: If you are giving birth in a hospital, I would need to deal with increased adrenaline issues anyway. It is unfortunate we can't monitor you and allow you move movement, but it just isn't safe.
Me: What if I refuse constant monitoring?
Dr. W: Then I would send you home and not induce.

Well, at least we understand each other. Honestly, I am now less afraid of a hospital induction than I was before the appointment. At least I know what it might look like and where I might win an argument and where I might not. Knowing that I can give my body and LB at least another week to let things happen is the best news, of course. If it does come to a hospital induction, I will be more likely to agree with the need at 42 weeks than I do nowl.

One other little tidbit. When I was looking at pictures yesterday to do my post, I came across the ones I took of Belinda before we cycled. It occurred to me that LB's ultrasounds do look a bit like her. I was ok with that. It is what it is. Hopefully that means progress.

11 comments:

Geohde said...

Good luck with LB making a grand entrance uninduced in the next week. Fingers crossed for you :)

J

Kay said...

Hoping for a Non-induced labor!!!
Come on LB, you can do it!!

theclam said...

Fingers crossed that all goes well and that the induction talk is just that - a talk.

niobe said...

Good that you were able to get more information -- even though I'm hoping it'll all be irrelevant soon.

Freyja said...

I'm pretty sure that means progress. :)

stacyb said...

great news kami -- really good that you spoke with the doc about everything -- our doula did the same for us -- helping us understand what might happen the big picture which made asking questions and understanding andwers that much easier.
your doula can really protect your space if you do end up going to the hospital. that said i'm keeping fingers and toes crossed that you'll be able to have the home birth you'd like to have.

MrsSpock said...

I hope things go well and you have a lovely homebirth. That said, I was dreading the idea of being induced myself. Given my experience with working with anti-natural coworkers, I was afraid the nurses at my new hospital would be the same. Even though my birth went awry, I am not unhappy with it. The nurses exceeded my low expectations. My midwife respected my wishes. And my doula was a lifesaver. Yours sounds the same. Even with Pit running, I didn't need help coping until they maxed it. Would the doc consider foley bulb induction? Mine took me from where you are now to 5 cm and 75%. I myself wouldn't consent to Cytotec- Ina May campaigns strongly against it. Cervidil is the better choice IMHO.

Amy said...

Hoping LB decides to make his/her entrance non-induced.

stacyb said...

great news kami -- really good that you spoke with the doc about everything -- our doula did the same for us -- helping us understand what might happen the big picture which made asking questions and understanding andwers that much easier.
your doula can really protect your space if you do end up going to the hospital. that said i'm keeping fingers and toes crossed that you'll be able to have the home birth you'd like to have.

Michell said...

Fingers crossed and all that hoping that in the next few days LB decides to come on out and you can do all of this at home.

Summer said...

I always find it easier to deal with a situation if I know better what to expect, even if what to expect isn't what I hoped for.

I'm glad you are feeling more assured. Like the others, I hope all this will be moot and you get to meet LB within the week.