Friday, April 5, 2013

Staring down 40 weeks

This week has been a hard one. Fielding two active kids on Spring Break at 39 weeks pregnant - not so much fun! At least they are at the point in life where their expectations of Spring Break are relatively low. And honestly, Leif would rather spend the week at home (playing anything electronic, or lately, reading). Skadi on the other hand - STIR CRAZY. AB stayed home Thursday to help me - which really was wonderful, even if it means he will have less time home with me and the baby after he arrives. (I say this now...)

I had originally had an appointment scheduled for Tuesday morning, but Dr. M had to cancel as he was in a complicated delivery. I was rescheduled to today, April 5th, 39 weeks 6 days. I was starting to get a little nervous going so long between appointments at such a late point in the pregnancy.

It was a nice, relaxed appointment today though as AB was there and Dr. M had few patients scheduled since he only normally works Tuesday and Wednesdays. So we took the time to sit and talk about options.

I went in expecting to be sent in for an induction. But he really left it up to me. How do I feel  - am I going absolutely stir crazy, how is my frame of mind, how is the baby doing? We decided to take into consideration a number of factors and tests to decide the path forward (not surprising for me as a scientist - I need data).

First step - bp and weight. BP was 102/68 (shockingly low at this late point) and no weight gain since last week.

Second step - Office exam, measuring right at 40 weeks (again), head down, and cervix check. My cervix is still very high (ouchie mama that exam was not fun). 1 cm dilated (still), but effaced and cervix is soft. Contractions are doing something if at least slowly. I have never dilated easily, so this is an accomplishment for me.

Third step - Mental. Yes, I am tired. But it is only a few days to try and give him more time to come on his own. I can do that. I am strong. I don't feel like a number of those women I have heard crying and begging for an induction. When it comes down to it, I am happy, a little weepy (stupid emotional commercials), a little hot headed when people constantly barage me with "how are you doing" or stupid questions that don't help the situation or offer their advice. I don't want a c-section. AB doesn't have the time off to help me recover from a c-section and I know I can deliver vaginally. An induction comes with an increased risk of c-section and since my cervix is just barely ready if it really is (I actually am not completely sure, but Dr. M has concerns about inducing and I trust him), this concerns me.

Fourth step - Family Birthing Center. Non-stress test showed (not surprising to AB and I) one extremely active baby. No significant contractions going on, regular heart rate with typical accelerations. Ultrasound was aimed to assess fluid levels (my fluids have been high to this point, but we don't want low fluids), and fetal size. They also do a sort of non-stress ultrasound for the baby where they count inhalations, back arching and hand flexing. Hand flexing passed with flying colors as we watched him play with the umbilical cord. Inhalations passed well as did the back arching. Fluid levels were normal and fetal size was determined to be "average". The measurement comes with a +/- 1.5 lbs error, but he was assessed at 8.5 lbs +/- 1.5 lbs.

Given all this combined the baby is not at risk, my mental state is sound, fluids are good, no concerns for size (I suppose...), we decided not to induce today and I was released from the hospital. We opted to try to give it over the weekend to go into labor. If that doesn't happen then we reassess Monday morning.

As AB and I left the birthing center he said, "I have such good memories of this place and am excited to be back." We have had nothing but fabulous, caring nurses, a great ob that prefers low intervention routes.

So there, that is the news. Don't feel slighted if I don't respond to incessant inquiries about how I am doing, respond to questions that call into question my doctor's and our decisions, or pay attention to everyone's suggestions about what I can do to trigger labor. I am frankly tired of ongoing contractions and worn out and sore from waking up in the morning after a long night with hour long sets of contractions that fizzle out. I prefer to give the baby every opportunity to come naturally and thus increase my chances of a third successful vaginal birth. (Yes, really, I have been here before, I am not a newbie!)

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