Decisions, Decisions

Today at my obstetrician appointment, my doctor was obviously disheartened to learn that I haven’t made any progress toward ejecting this baby boy of mine. As a matter of fact, she said that it seemed like my cervix was even farther back than it was two weeks ago.

She also confirmed what I suspected this morning–my son isn’t all lined up and ready to go anymore. He has pulled his head out of my pelvis and has it firmly planted in my left hip region (which she said explains the cervix feeling more posterior than it did previously).

Next Monday, I will be 40 weeks. I asked her what, if anything, will be changing about my appointments if I go past the 40 week mark. She said starting next week, she would like to begin seeing me twice a week (did I mention she is about an hour away from where we live?) to complete twice weekly non-stress tests so she can keep an eye out for a failing placenta. She said whether I get cervical checks is completely up to me. She also said that she wants an ultrasound at the 41 week mark to check everything out and check his size.

My favorite part of the appointment was here, after she mentioned his size, she paused and asked me what did I think about his size (big/small/average). I told her that I thought he was still small because I was much more uncomfortable with my daughter at this stage than I am with him. Eva was only 7 lbs 2 oz when she was born at 39 weeks and 3 (or was it 4?) days. I also told her that it had been a long time, though, so my memory is fuzzy, but it definitely didn’t seem like he is abnormally large.

She then asked me how far I wanted to go before any interventions. I told her that I would go as long as I needed to if he isn’t showing any signs of distress. I also told her that because of my philosophy on this, I wouldn’t be consenting to an induction.

If things reach a point that she thinks he needs to come out, then she would need to make sure he really needs to come out very soon as in can’t wait another day. To me, in such a situation, that would mean a c-section is in the best interest of my son. I told her I would need to see that either there is obvious distress or it is obvious that the placenta is failing.

She agreed wholeheartedly with my statement. She said she does not like to use Pitocin on someone with a previous c-section anyway, so if I did want an induction it would be guaranteed to be a long process because she keeps the Pitocin at the lowest level possible. She also told me that right now, my body isn’t favorable to a successful induction (posterior cervix, still only barely dilated). So, she didn’t see a point in trying for an induction, either.

I forgot to ask her what she thinks about stripping membranes, but I’m quite sure I already know her answer. Her stance on pretty much everything touted to be labor-inducing is that if you aren’t already favorable to labor, right there on the edge, then it won’t make any difference.

We covered some differences in policy concerning c-section between the hospital where I previously had my c-section and the hospital at which I plan to deliver this go around. The last time, the hospital insisted on leaving the epidural in place for 12 hours following the procedure. It wasn’t delivering any medication after 8 hours, but it was still in place. At the new hospital, it comes out within a couple of hours, and the medication given is more similar to receiving a spinal block. The urinary catheter stays in for 12 hours, unless I really, really want it out sooner (which I doubt will happen because the first time I got up to pee post c-section was beyond horrible for me, and that was about 16 hours post-op).

I also told her that the anesthesiologist last time gave me some kind of anti-anxiety medication as soon as my daughter was out without asking for my consent. I was not okay with this. She kind of looked shocked by this and then reassured me that this wasn’t something that happens in her OR.

I need to ask her about skin-to-skin in the event of a c-section, I suppose, but I still fully plan on going into labor one of these days soon. I still have time, and my son is still doing just fine. He has responded well to every non-stress test so far and he is still active. We have no reason to think that we won’t be able to do this naturally still.

As we were wrapping things up, she asked me specifically (which I found surprising) to name a week/end date. I told her we would just have to wait and see how things are going at 42 weeks, but that she should keep her fingers crossed that I go into labor before then. She nodded and held up crossed fingers for me. She also said she would check to see how busy things were supposed to be on the 42 week mark in the morning, in case we decide to schedule a c-section. I know she will be really, really hesitant to go any further than 42 weeks because of my gestational diabetes. I will have to be very sure that he is fine to convince her to continue without c-section at that point.

All in all, it was really nice to hear her asking me what I was thinking/feeling and then listening. She seemed doubtful that I would be able to stand the physical discomfort all the way to 42+ weeks, but I reassured her that this isn’t about my level of comfort at all and that I have been through a c-section before and being uncomfortable for a couple of extra weeks still hands-down beats a c-section recovery. No contest there. I still don’t think she believes me. But, I suppose many women need things to happen within a certain timeline for work and maternity leave and the added discomfort on top of that financial stress can result in a woman begging to get that baby out RIGHT NOW! This was definitely my reality when I was 39 weeks with Eva.

So, fingers crossed and prayers up that labor happens sometime in the next couple of weeks so we don’t even have to evaluate the need for a c-section!

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12 Replies to “Decisions, Decisions”

  1. I admire your patience and that you are really trying to do what is in the best interest of the baby. It is so nice to read about a doctor that listens and works with you instead of pressuring you to fit their schedule. I doubt you’ll have to go all the way to 42 weeks…but you’ll be ok anyhow! I went to 41w1d and it was crazy uncomfortable but you manage 🙂

    1. Thank you! I am really lucky to be self-employed otherwise I suspect this patient attitude wouldn’t work out financially/professionally. I do have a good doctor, for sure! Wouldn’t trade her for the world. I’m almost hoping to get more uncomfortable because I feel like that will be a sign he will be here soon! Ha! I’m gonna eat those words in a week or so!

  2. Amazing doctor! Terrific! I realize after reading this that I may have commented to you before that my induction experience was pretty smooth. I now realize how different our circumstances were/are. First, I hadn’t realized you’d had a c-section previously. That makes a huge difference! When I was induced with baby #2, I was already dilated to 3 (or was it 4?) and was starting to lose my mucus plug. Baby’s head was very low and I was 75% effaced. So things were progressing by that point anyway. But because I had been suffering in such tremendous pain with kidney stones for 3 days by that point, having gotten no more than 10 minutes of sleep at a time during those 3 days (that was how often I could self-administer the pain meds, and if I went longer than 10 minutes in favor of sleep I was literally screaming and writhing in pain) we eventually made the collective decision that induction was best. I had already gone 72 hours without sleep so they were concerned about my being too exhausted to even deliver the baby at all. Plus the pain management was clearly an issue, and of course they couldn’t do anything to help the kidney stone along, or even do a scan to see how big it was, until baby was out (I was 39 weeks).

    All that rambling aside, you and your doctor have a great plan in place and I’ll be thinking of you!

    1. That sounds like maybe labor would have already started if you weren’t in so much pain AND exhausted! Man! I’m glad it went so smoothly for you. I appreciate all thoughts headed my way! Thank you!

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