So, we're about 57 hours or so from our induction appointment, and, as I tend to do before any big life event, I "decided" to melt down emotionally last night and today. As I recall, we got married on Sunday nearly 7 years ago, and on the Friday night previous to the ceremony I flipped out under the pressure. By the day of the wedding I was ready to go, and I hope that by Monday I will be the same! So, while unpleasant, this development wasn't unexpected.
I didn't sleep last night worrying that the induction of labor was the wrong choice. However, what I didn't realize at the time was that the worries I was experiencing were a result of accepting the wrong presuppositions. Basically, I had assumed that the "reasons" we had been discussing as justification for induction were limited to the two on my mind, which were not, on their own, reasons to induce, which made it boil down to an elective procedure. I made this mistake because in talking to the doctor, we had agreed with the course of action he proposed without having heard his reasons for it, which meant he hadn't actually spelled out the case for us, so we just operated on what was in our minds until those reasons failed to justify the action.
Some elective procedures I'm okay with, but not those that take two lives into the balance when nature has been doing a pretty good job of accomplishing the same thing since the advent of humanity. So, I fretted and read and worried and cried off and on for 12 hours until finally, mercifully, had an appointment with our OB just before office closing time.
We left the office with a completely different perspective, because what we got in this visit was his professional opinion: that I am at substantially above average risk for adverse outcomes as pregnancy progresses, which means that there is more risk inherent in leaving the baby where he is than there is in urging him out while we know he's healthy now that he has reached a very favorable point in development.
He gave me three medical reasons having to do with my own personal status and health:
1. I am right on the cusp of "advanced maternal age" and the risks that attend it, and there is nothing magical that happens on my quickly-advancing 35th birthday that might not be an issue now.
2. My blood pressure is borderline high, which increases risk to the baby.
3. My gestational diabetes - which can cause premature aging of the placenta, such that it fails to provide adequate oxygen and nutrition to the baby as pregnancy progresses, and which also places me at higher risk of developing pre-eclampsia - is an ongoing concern.
He proviced one reason that is his own selfish motive and not a real reason for us:
4. He would get to attend the delivery.
And one reason that is evidence-based statistical data about fetal outcomes at various gestational ages:
5. Fetal morbidity based on gestational age at delivery decreases from an already low rate at 36 weeks to its lowest at 39 weeks before increasing again at 40 weeks and beyond. This is without regard to particular maternal risk factors - babies born at 39 weeks, for reasons that are not entirely intuitive or clear, just do better.
To these 5 reasons we can add two more:
6. We're both exhausted, physically and mentally, by the pregnancy and its complications.
7. There would be an advantage to getting antibiotics in a timely manner, which is more likely with an induction than with spontaneous labor, given how far advanced I am already at this stage.
None of these reasons is compelling on its own, and even a combination of 2 or 3 is not enough to make it wise; they are "soft" concerns. However, when we add them all up, they spell higher risk that it makes sense to more actively manage, which means there is a medical case for induction, making this a choice, yes, but not a purely elective procedure.
We have heard nothing but good things about our doctor from the nursing staff at the hospital, people in his office, other doctors at the hospital, and even the guy that sold Daniel his suits (his own kids were delivered by him 2 decades ago) at Men's Warehouse, and so when our judgment is wanting direction, it seems like his opinion is worth trusting.
Our choices, he said, are two:
1. Proceed with the induction on Monday
2. Choose not to proceed with the induction - which is fine as long as the baby looks healthy now - but, if I do, I will need to begin twice-weekly non-stress tests immediately to make sure that the baby's health is not deteriorating as he and the placenta age, and if the baby is not born by week 41 due to an emergency or spontaneous labor, induction would become extremely strongly advised.
He explained his professional opinion but he also stressed, quite honestly and supportively, that it is our pregnancy and that the choice is absolutely up to us and that he won't force the issue aside from ordering more tests if we refuse. He then answered my specific questions about the risks and benefits of both approaches for about 40 minutes. He was very straight-talking, which I really appreciate. He also said that if he felt like an induction was absolutely necessary, he would not mince words about that. We have a choice, essentially, as long as the baby looks okay and my health holds up, but we also have and the benefit of his opinions as to why he feels strongly that induction at the gestational age the baby will have reached on Monday is the safer course.
After he did the usual exam, which didn't show any growth of the uterus for the last 2 weeks and showed a lower-than-usual fetal heart rate (still acceptable, but on the slow end of the scale), I was sent to have a decidedly more scientific examination: a non-stress test done at the hospital, which was performed tonight. I had instructions that if it did not look good, the doctor from the practice that is on-call this weekend would order more tests or even deliver us immediately. If we passed the test, on the other hand, then we should be fine until Monday's planned induction, or non-stress test, if I refuse the induction.
Thankfully, we passed, which means we still have the choice, and the opportunity for spontaneous labor in the meantime.
So, after the test, lots of talking and taking into consideration the factors that were presented to us, I'm again feeling more peaceful about the possibility of induction. Hopefully I will now be able to just chill out and accept what may come. I would love to have labor begin spontaneously between now and then (the doctor on call this weekend is my second favorite in the practice, and I would much prefer a more natural process if that is possible), but I also feel like it can be the wise and loving thing to proceed with induction on Monday if it does not. So... it looks like we'll most likely have a baby on his way out sooner than later, and it is a fun thing to contemplate... if also the scariest thing I have faced in a LONG time!
Friday, July 31, 2009
Wednesday, July 29, 2009
Aside... CA legislation I REALLY hope passes!
I have read quite a lot about lately about the risks/benefits of fire retardants in baby items. I have come to believe that the benefits do not justify the risks. There is proposed legislation in CA that would change the requirements in CA, which would, in effect, change them for the rest of the US, since manufacturers tend to manufacture to the most stringent codes, which, in this case, would be the codes in CA. I would LOVE to be able to buy products that have not been treated with flame retardants, so I hope this legislation or similar manages to pass. Click on the title of this post to read the LA Times piece that spurred these comments.
Monday, July 27, 2009
The more things change...
...the more they stay the same.
So, the doctor says, giggling through much of the appointment, that I am at 3-4cm "I can see someone calling it 4cm" and 80% effaced. I think he was giggling during the appointment because I keep coming back to see him in the office instead of just showing up at the hospital in labor like I am apparently supposed to. It's that pesky "in labor" part that is the hang up. It's not for lack of trying. In fact, when he checked me out, I harbored the secret hope that he'd find I was at 5-6cm and would just send us to the hospital. Not that I thought he would, mind you... but a girl can dream.
OBs use something called the "Bishop score" to rate the likely success of labor induction, and the higher the score, the less likely a conversion to a c-section because of failure to progress through labor (keeping in mind that a c-section may still be needed for other reasons). Well, he says, again laughing, as he prepares to leave the room: "You have a very favorable Bishop's score. In fact, it is about as high as it can get for a first-time mom." As Daniel remarked to me on the way to the car, "you always were a high achiever." Yes, that's me... going for the good scores!
They don't ask my name at the front desk anymore. Instead, they just ask who I am seeing today. Mondays are my usual appointment days, but I have been given an extra Friday appointment this week just to see if "anything has changed" before I show up before sunrise next Monday. Before we left, we ironed out a few of my concerns about the induction scenario (like making sure that it is in the written orders I have to take to the hospital with me that I am to start antibiotics 1 hour before they start with the actual induction), so that is comforting.
Many women have an elaborate "birth plan" outlining everything that they want/don't want from the birth experience. It includes important things, usually, like pain relief preferences, and may extend to details like how bright the lights are in the birthing room and what sort of music they want playing while they manage their contractions. I have decided that my birth plan is going to be one sentence (we were encouraged to make our plans clear and succinct): "Talk to us before you do anything to me or the baby, unless one of our lives depends on immediate action, and if I'm not able to make decisions for some reason, please have the discussion with my husband." There's plenty of control-freakishness in the spirit of this plan, yes... but this is from the same person who programs trips down to the hour and minute and writes three pages of instructions for the pet sitters when "please make sure the cats are fed, healthy, and have a reasonably clean litterbox" would probably suffice, so I am feeling like this is a big step for me. The last three weeks have been a rather pointed reminder that I am not in control of when or how this baby comes, but to the extent that I can make choices once at the hospital, I do want to be given the opportunity.
That's it for now. And with that... back to my book while I have the luxury of reading!
So, the doctor says, giggling through much of the appointment, that I am at 3-4cm "I can see someone calling it 4cm" and 80% effaced. I think he was giggling during the appointment because I keep coming back to see him in the office instead of just showing up at the hospital in labor like I am apparently supposed to. It's that pesky "in labor" part that is the hang up. It's not for lack of trying. In fact, when he checked me out, I harbored the secret hope that he'd find I was at 5-6cm and would just send us to the hospital. Not that I thought he would, mind you... but a girl can dream.
OBs use something called the "Bishop score" to rate the likely success of labor induction, and the higher the score, the less likely a conversion to a c-section because of failure to progress through labor (keeping in mind that a c-section may still be needed for other reasons). Well, he says, again laughing, as he prepares to leave the room: "You have a very favorable Bishop's score. In fact, it is about as high as it can get for a first-time mom." As Daniel remarked to me on the way to the car, "you always were a high achiever." Yes, that's me... going for the good scores!
They don't ask my name at the front desk anymore. Instead, they just ask who I am seeing today. Mondays are my usual appointment days, but I have been given an extra Friday appointment this week just to see if "anything has changed" before I show up before sunrise next Monday. Before we left, we ironed out a few of my concerns about the induction scenario (like making sure that it is in the written orders I have to take to the hospital with me that I am to start antibiotics 1 hour before they start with the actual induction), so that is comforting.
Many women have an elaborate "birth plan" outlining everything that they want/don't want from the birth experience. It includes important things, usually, like pain relief preferences, and may extend to details like how bright the lights are in the birthing room and what sort of music they want playing while they manage their contractions. I have decided that my birth plan is going to be one sentence (we were encouraged to make our plans clear and succinct): "Talk to us before you do anything to me or the baby, unless one of our lives depends on immediate action, and if I'm not able to make decisions for some reason, please have the discussion with my husband." There's plenty of control-freakishness in the spirit of this plan, yes... but this is from the same person who programs trips down to the hour and minute and writes three pages of instructions for the pet sitters when "please make sure the cats are fed, healthy, and have a reasonably clean litterbox" would probably suffice, so I am feeling like this is a big step for me. The last three weeks have been a rather pointed reminder that I am not in control of when or how this baby comes, but to the extent that I can make choices once at the hospital, I do want to be given the opportunity.
That's it for now. And with that... back to my book while I have the luxury of reading!
Monday, July 20, 2009
The continuing saga of baby J
We visited the doctor again this afternoon. Things are much as they have been - I'm still 3+ cm dilated and a full 80% effaced and he is at -2 station, which, we are told, is pretty low for not being in active labor.
After talking to the doctor more about my situation, we opted to schedule a date for an induction if I do not go into natural labor in the next 2 weeks. So, on 5:15 am on August 3, if not before, we'll be at the hospital. I'm not a fan of induction in principle, unless a baby is overdue, but the consensus is that I am likely to have a quick labor (I've been instructed multiple times not to dilly-dally getting to the hospital when labor starts), I'm a good candidate for successful induction, and we decided together that there may be some definite advantages for the baby if we induce, because that would mean we can have a better shot at having enough time to get sufficient penicillin in my system to lessen his strep risks before he is born than we might otherwise have with natural labor. So, it's really not about being impatient for him to get here -- although my increasing aches and pains make an earlier than later birth date sound rather nice -- it was a matter of increased safety in delivery if he has not come on his own.
Baby is, as it were, poised at the starting blocks and waiting for the signal to run. As for the grown-ups, we are circling the airport for now, waiting to be cleared for landing. We'll see whether he sprints before the tower gives us the call.
After talking to the doctor more about my situation, we opted to schedule a date for an induction if I do not go into natural labor in the next 2 weeks. So, on 5:15 am on August 3, if not before, we'll be at the hospital. I'm not a fan of induction in principle, unless a baby is overdue, but the consensus is that I am likely to have a quick labor (I've been instructed multiple times not to dilly-dally getting to the hospital when labor starts), I'm a good candidate for successful induction, and we decided together that there may be some definite advantages for the baby if we induce, because that would mean we can have a better shot at having enough time to get sufficient penicillin in my system to lessen his strep risks before he is born than we might otherwise have with natural labor. So, it's really not about being impatient for him to get here -- although my increasing aches and pains make an earlier than later birth date sound rather nice -- it was a matter of increased safety in delivery if he has not come on his own.
Baby is, as it were, poised at the starting blocks and waiting for the signal to run. As for the grown-ups, we are circling the airport for now, waiting to be cleared for landing. We'll see whether he sprints before the tower gives us the call.
Monday, July 13, 2009
Progress...
We got to see our primary doctor today again, and we'll see him from here on out. He tends to have a calming effect on me, so I am voting for a Thursday birthday for baby if he decides to come this week, since that is when this doctor is on-call. Thursday would also have the advantage of being after the visit we are expecting from the Bells on Wednesday.
At today's appointment he answered several of my questions and did a quick check of all of the stats. Baby's heart rate was good and came in about 130bpm. My uterus is measuring 36cm, which is just right. He also did a quick check of my cervix, being careful not to disturb it too much so as not to encourage labor. He said the doctor I saw last week tends to be "generous" in her measurements, so he said he would have to see if he thought I was even to 3cm yet. Well, he said he thinks I am at 3, which he then revised to "3-plus" and he said that the cervix is thin, too, at 70-80% effaced, which implies that I have made progress towards active labor since last week. He said he'll see me in a week *if* I need that appointment. Nobody is making any guarantees, but it sure looks like I may not make it to the due date at any rate.
I never really mentioned how the visit with the pediatrician's office went... so, I'll just say that the doctor we met we liked, even though he wasn't the one we had been referred to. We learned that some of the folks from our OB group (ie. doctors and staff) bring their own children to that practice, so I also considered that a good endorsement. I think we'll stick with the office. They have a policy of trying to get kids in with their primary doctor whenever possible, and they have Saturday and Sunday hours for sick visits, which is very convenient.
So... the house is still rather a mess, largely because I keep wanting to tackle new projects. I think, though, that we're nearing the point where simply cleaning surfaces well would be the best use of our time and energy. We'll see what there is energy to do when Dan gets home this evening.
In the meantime, I think I may go make a final splurge for myself since Costco has sets of classic BBC literature adaptation movies on sale for 33% off starting today. We'll just call it something to watch at the hospital. ;)
At today's appointment he answered several of my questions and did a quick check of all of the stats. Baby's heart rate was good and came in about 130bpm. My uterus is measuring 36cm, which is just right. He also did a quick check of my cervix, being careful not to disturb it too much so as not to encourage labor. He said the doctor I saw last week tends to be "generous" in her measurements, so he said he would have to see if he thought I was even to 3cm yet. Well, he said he thinks I am at 3, which he then revised to "3-plus" and he said that the cervix is thin, too, at 70-80% effaced, which implies that I have made progress towards active labor since last week. He said he'll see me in a week *if* I need that appointment. Nobody is making any guarantees, but it sure looks like I may not make it to the due date at any rate.
I never really mentioned how the visit with the pediatrician's office went... so, I'll just say that the doctor we met we liked, even though he wasn't the one we had been referred to. We learned that some of the folks from our OB group (ie. doctors and staff) bring their own children to that practice, so I also considered that a good endorsement. I think we'll stick with the office. They have a policy of trying to get kids in with their primary doctor whenever possible, and they have Saturday and Sunday hours for sick visits, which is very convenient.
So... the house is still rather a mess, largely because I keep wanting to tackle new projects. I think, though, that we're nearing the point where simply cleaning surfaces well would be the best use of our time and energy. We'll see what there is energy to do when Dan gets home this evening.
In the meantime, I think I may go make a final splurge for myself since Costco has sets of classic BBC literature adaptation movies on sale for 33% off starting today. We'll just call it something to watch at the hospital. ;)
Thursday, July 9, 2009
Update
I recently received bad news that I consider to be good. I had interviewed for a job a few weeks ago, and I got the rejection letter in yesterday's mail. My *ideal* is being a stay-at-home mom, at least while my kids are little, but I can work and would work if I need to. While I have seriously applied for work every week since October, I have only had one interview and little else that counts as serious interest in me, all of which I have taken as a sign that I'm not meant to be working in the near future. There's no need for me to comment on the state of the economy or the fact that my expertise isn't exactly in high demand in central North Carolina... suffice it to say that, under other circumstances, the fact that I am not in demand might make me feel a little less than confident about myself. I have chosen, however, to see this lack of opportunities as God's will, so it's not so much disapponting as it is something of a relief. I don't have to make a choice about working right now!
The interview came as something of a shock after such a dry spell, and I felt it was important to take the interview and the opportunity seriously, to look at how our lives would be different if I got the job, and to explore it all with an open mind. I did just that and lived with the uncertainty of the possibility for a few weeks. That's why this rejection is good news. I can close the door on this opportunity, knowing that I put my best foot forward when interview time came. I can also rest again in the feeling that the right opportunity has not come along, which means I can continue putting job feelers out, as I need to, while feeling the freedom to return my focus to being a mom when the time comes.
We also got news today that while not good is helpful. I'm becoming more stoic as this pregnancy progresses, because it seems like a lot of the factors that can complicate matters end up being an issue for me and I have figured out that my job is to just do what I can and let God take care of the rest. Talk about a lesson in letting go for the control freak in me... I can't control a great many things about this new life in me, so the more accepting I can be of the way things are, the better. The latest news is that I am in the 15-40% of strep B carriers. The baby could contract the bacteria from me during the birth process (about 50% of babies will) and could become very ill, suffer permanent disability or even die -- if active illness results. The odds of that happening are lower by far than the odds of picking up the bacteria, but it is one more thing to have to think about and another reason to hope that baby holds on for another couple of weeks, because the risks to a baby born before 37 weeks are increased 8-fold. What it means practically is that I will be given penicillin during labor, which itself is a trade-off. It should help reduce the risk of strep B infection, but it also may make the baby more susceptible to E-coli and other harmful organisms. Like I said, the news isn't good, but it is helpful, since I would rather have a positive culture and know what we are dealing with than a false negative, which happens often enough to be a bit scary. If I have a nice quick labor like some of the other females in our family, then the potential exposure time for the baby should be reduced, even if they don't manage to get me on the antibiotic IV 4 hours before I deliver, which is the ideal.
We've been working on getting the house cleaned up little by little, and last night we unpacked the carseat and got acquainted with its workings, since I figure that's one thing we won't want to be working out with a baby in arms. A lot of other things remain in boxes, and I suppose we will either unpack them slowly over the next few weeks before baby arrives, or we may wait (out of necessity born of a sooner-than-later trip to the hospital or choice) until he's here to unpack some of them. We're headed to the last of our regular childbirth classes tonight (we'll go to an optional extra session next Thursday on natural pain control techniques if we are able), and I should find out on Monday if the cramping and contracting I have been feeling this week has moved me any closer to active labor. We're also visiting our very scientifically-selected pediatrician's office (I asked a local mom in a Target restroom who has two kids - one with special needs - whom she recommended, and took her recommendation) this afternoon. I don't really have a backup plan for the pediatrician, so if we don't like the office, I suppose we'll have to go back to square one. I don't want to choose a physician based on a website or random web recommendations, and I don't really know anyone local with kids to ask, so we're going to wing it at first.
Daniel has been finishing up his dental work, so he was half-numb yesterday and is suffering from post-dentist jaw pain. He's doing a wonderful job of being supportive around the house anyway, so I am eternally grateful.
I guess that's it, aside from noting that I am back to sleeping much of the morning off and on because I am just wiped out. Because of my eating and testing schedule, I never have more than an hour and a half to sleep at a time once I get up in the morning, so I suppose I should consider this practice for catch-as-catch-can sleep that will, we hope, become the norm quite soon. Not that we wouldn't like to sleep through the night... we just look forward to this particular disruption. :)
The interview came as something of a shock after such a dry spell, and I felt it was important to take the interview and the opportunity seriously, to look at how our lives would be different if I got the job, and to explore it all with an open mind. I did just that and lived with the uncertainty of the possibility for a few weeks. That's why this rejection is good news. I can close the door on this opportunity, knowing that I put my best foot forward when interview time came. I can also rest again in the feeling that the right opportunity has not come along, which means I can continue putting job feelers out, as I need to, while feeling the freedom to return my focus to being a mom when the time comes.
We also got news today that while not good is helpful. I'm becoming more stoic as this pregnancy progresses, because it seems like a lot of the factors that can complicate matters end up being an issue for me and I have figured out that my job is to just do what I can and let God take care of the rest. Talk about a lesson in letting go for the control freak in me... I can't control a great many things about this new life in me, so the more accepting I can be of the way things are, the better. The latest news is that I am in the 15-40% of strep B carriers. The baby could contract the bacteria from me during the birth process (about 50% of babies will) and could become very ill, suffer permanent disability or even die -- if active illness results. The odds of that happening are lower by far than the odds of picking up the bacteria, but it is one more thing to have to think about and another reason to hope that baby holds on for another couple of weeks, because the risks to a baby born before 37 weeks are increased 8-fold. What it means practically is that I will be given penicillin during labor, which itself is a trade-off. It should help reduce the risk of strep B infection, but it also may make the baby more susceptible to E-coli and other harmful organisms. Like I said, the news isn't good, but it is helpful, since I would rather have a positive culture and know what we are dealing with than a false negative, which happens often enough to be a bit scary. If I have a nice quick labor like some of the other females in our family, then the potential exposure time for the baby should be reduced, even if they don't manage to get me on the antibiotic IV 4 hours before I deliver, which is the ideal.
We've been working on getting the house cleaned up little by little, and last night we unpacked the carseat and got acquainted with its workings, since I figure that's one thing we won't want to be working out with a baby in arms. A lot of other things remain in boxes, and I suppose we will either unpack them slowly over the next few weeks before baby arrives, or we may wait (out of necessity born of a sooner-than-later trip to the hospital or choice) until he's here to unpack some of them. We're headed to the last of our regular childbirth classes tonight (we'll go to an optional extra session next Thursday on natural pain control techniques if we are able), and I should find out on Monday if the cramping and contracting I have been feeling this week has moved me any closer to active labor. We're also visiting our very scientifically-selected pediatrician's office (I asked a local mom in a Target restroom who has two kids - one with special needs - whom she recommended, and took her recommendation) this afternoon. I don't really have a backup plan for the pediatrician, so if we don't like the office, I suppose we'll have to go back to square one. I don't want to choose a physician based on a website or random web recommendations, and I don't really know anyone local with kids to ask, so we're going to wing it at first.
Daniel has been finishing up his dental work, so he was half-numb yesterday and is suffering from post-dentist jaw pain. He's doing a wonderful job of being supportive around the house anyway, so I am eternally grateful.
I guess that's it, aside from noting that I am back to sleeping much of the morning off and on because I am just wiped out. Because of my eating and testing schedule, I never have more than an hour and a half to sleep at a time once I get up in the morning, so I suppose I should consider this practice for catch-as-catch-can sleep that will, we hope, become the norm quite soon. Not that we wouldn't like to sleep through the night... we just look forward to this particular disruption. :)
Monday, July 6, 2009
Moving right along!
News today is that I am 3cm dilated, 50-60% effaced and baby is head down and at -2 station. The doctor believes I could have the baby as soon as this week or next, although we'd all prefer that he holds on until 37 weeks. In any event, she says she doubts I will make it to the due date. I'm also, apparently, the sort of patient who "doesn't need to wait for 2 full hours of contractions" before getting myself to the hospital, because things are "favorable" for a labor that progresses quickly, so after one hour of 5-7 minute contractions, I should call the office and get myself to the hospital with my bag.
Daniel and I were both rather surprised by the news, to say the least. He wasn't expecting any dilation, and I was, more generously, prepared for maybe 1cm. We've been rather giddy since we left the office.
The house is a disaster because of some of the nesting I have been wanting to do, and the sense of urgency we felt last week is growing exponentially. I'm hoping that we are able to get the place cleaned up before I go to the hospital.
Baby is 35 weeks 1 day today, so he would be premature if he came this week. The doctor said there would be about a 20-30% chance that he would require a NICU stay of 1-2 weeks if he is born this week, so we'd prefer that he waits about 2 weeks.
Your prayers are appreciated!
Daniel and I were both rather surprised by the news, to say the least. He wasn't expecting any dilation, and I was, more generously, prepared for maybe 1cm. We've been rather giddy since we left the office.
The house is a disaster because of some of the nesting I have been wanting to do, and the sense of urgency we felt last week is growing exponentially. I'm hoping that we are able to get the place cleaned up before I go to the hospital.
Baby is 35 weeks 1 day today, so he would be premature if he came this week. The doctor said there would be about a 20-30% chance that he would require a NICU stay of 1-2 weeks if he is born this week, so we'd prefer that he waits about 2 weeks.
Your prayers are appreciated!
Thursday, July 2, 2009
Hospital Tour
Some thoughts after returning from our childbirth class 4th session tonight...
1. The two babies that were in the nursery when we were taken through the maternity floor were SO cute and tiny! I could have stared at them all teary-eyed all night, but, alas, we had places to go and medical equipment to see.
2. The RN class instructor (the first health professional I have seen since developing the suspicion that baby has "dropped") concurred that it looks, externally at least, like he has, when I mentioned my suspicion to her.
3. I managed the walking tour on my own two feet! Hooray! I had to email ahead saying that I might have need of a wheelchair if my hip acted up. It didn't and I didn't and that was great.
4. We learned a bit about hospital philosophy on the tour, including that they have made a shift toward a more family-centered experience, which means, among other things, that they encourage babies rooming with mom nearly 24/7 after a 30-minute visit to the nursery to make sure that baby is healthy.
5. I'm even more anxious for my OB appointment on Monday, now, after seeing the poster of fetal presentations that increase the likelihood of cesarean section. I would like to know if baby is head down now, because if I had to guess based on what I feel when he wiggles, I would say he may be transverse. My thought at the moment is that if that's true, I'm not really a fan of external version unless it is done in the hospital setting just before birth because of the risks of fetal distress... if they did it outpatient and sent me home I would worry intensely. So, that might be one of the things that would make me think that an induction at 39 weeks (which my doctor has said he would do if I wish) might be a good idea, if I can get a combo deal of version plus induction and be monitored at the hospital so that they can do a quick c-section if version fails or the baby is in distress.
6. When asked to choose which options on the front or back of cards we preferred (one card, for example, had "no medications" on one side and "Epidural" on the other), I discovered that my leaning is toward a more "natural" birth with fewer interventions in terms of medication and invasive procedures, with the exception of constant monitoring of fetal and maternal well-being. Of that medical innovation I am a big fan! We'll see if I still have the "natural is nice" opinion when I am the one in the birthing bed!
1. The two babies that were in the nursery when we were taken through the maternity floor were SO cute and tiny! I could have stared at them all teary-eyed all night, but, alas, we had places to go and medical equipment to see.
2. The RN class instructor (the first health professional I have seen since developing the suspicion that baby has "dropped") concurred that it looks, externally at least, like he has, when I mentioned my suspicion to her.
3. I managed the walking tour on my own two feet! Hooray! I had to email ahead saying that I might have need of a wheelchair if my hip acted up. It didn't and I didn't and that was great.
4. We learned a bit about hospital philosophy on the tour, including that they have made a shift toward a more family-centered experience, which means, among other things, that they encourage babies rooming with mom nearly 24/7 after a 30-minute visit to the nursery to make sure that baby is healthy.
5. I'm even more anxious for my OB appointment on Monday, now, after seeing the poster of fetal presentations that increase the likelihood of cesarean section. I would like to know if baby is head down now, because if I had to guess based on what I feel when he wiggles, I would say he may be transverse. My thought at the moment is that if that's true, I'm not really a fan of external version unless it is done in the hospital setting just before birth because of the risks of fetal distress... if they did it outpatient and sent me home I would worry intensely. So, that might be one of the things that would make me think that an induction at 39 weeks (which my doctor has said he would do if I wish) might be a good idea, if I can get a combo deal of version plus induction and be monitored at the hospital so that they can do a quick c-section if version fails or the baby is in distress.
6. When asked to choose which options on the front or back of cards we preferred (one card, for example, had "no medications" on one side and "Epidural" on the other), I discovered that my leaning is toward a more "natural" birth with fewer interventions in terms of medication and invasive procedures, with the exception of constant monitoring of fetal and maternal well-being. Of that medical innovation I am a big fan! We'll see if I still have the "natural is nice" opinion when I am the one in the birthing bed!
Wednesday, July 1, 2009
Update at Due Date minus 39 days
Pregnancy has crawled by and flown by. The first trimester lasted an eternity, and now the due date is only a little over a month away and that seems awfully soon. All of the sudden the fact that I will be giving birth in the near future has become quite real. Some of the signs of the end have started to appear:
1. The doctor told me on Monday that if I go into labor at week 35 they will not try to stop it and I will just have the baby. I replied, "But that's next week!" He nodded. I went into mild shock.
2. Sometime between that doctor visit and the next morning I believe the baby "dropped" or at least began to descend. My tummy has changed shape, and I can no longer see my hybrid navel (half innie, half outie) without looking in the mirror. They say this happens in first pregnancy about 2-4 weeks before the beginning of labor, but I may prove exceptional in this regard, too, and stretch it out longer or manage to wind up in labor sooner.
3. About the same time, I started having shooting pains in my right hip, along with the conviction that at the slightest provocation my hip would pop right off of my pelvis. Okay, so that's unlikely, but it sure feels like it when I stand up to discover that it is hip fun time.
4. I have this very urgent desire to do several things before the baby comes, such as going to a movie in a theater (which we did on Monday) and going to a baseball game for a local team (which we have yet to do). In short, I am wanting to do the things I think won't come easily in a month or so, and while I am afraid to buy tickets to anything in advance, if I feel up to a trip out to do anything fun, I've become quite spontaneous about doing it.
5. I've started nesting. I think I have done about 5 loads of laundry and a load of dishes today. I even rearranged some things downstairs to make room for the pack-n-play. This is unusual for pregnant me. Seriously.
6. I have started watching birth-related TV shows like there is no tomorrow. I then cry at every birth and watch another one a few minutes later. *sigh*
7. I'm still following the rules quite faithfully, but I am getting really tired of my gestational diabetes lifestyle and am counting down to the due date with all of the insane fervor of the ice-cream-deprived pregnant woman I am. I don't crave pickles and ice cream, but the ice cream alone would be such a marvelous indulgence... it makes me weepy to think about it!
8. I've graduated to OB visits every week.
In short, I'm fine... if a little worried that the hip issue will make me less mobile in a hurry and a tiny bit concerned about the prospect of preterm labor. I'm looking forward to my next OB appointment, since they will be checking my cervix. I have begun to wonder if I have any other physical signs of preparation for labor, and that will likely tell me about one of the most critical. My blood pressure is also creeping back up a little, so I will be keeping a close eye on that. I'm not feeling too anxious for it all to be over yet since it's really too early for the little guy to make his appearance and that knowledge tempers my enthusiasm, but I am looking forward to the next step in the journey and can see how I will probably ramp up my expectations as the days and weeks pass.
Baby seems to be fine, too. His heartrate is around 130 and he's measuring 1 cm large, which is exactly what he has been since they started measuring. That's a good sign, and that he's not growing any bigger than that may be part of the payoff for my lifestyle discipline. He seems to be a bit more cramped in there, but he can still manage to beat up my insides pretty well.
Yeah... we're looking forward to meeting him... but we can wait a few weeks! :)
1. The doctor told me on Monday that if I go into labor at week 35 they will not try to stop it and I will just have the baby. I replied, "But that's next week!" He nodded. I went into mild shock.
2. Sometime between that doctor visit and the next morning I believe the baby "dropped" or at least began to descend. My tummy has changed shape, and I can no longer see my hybrid navel (half innie, half outie) without looking in the mirror. They say this happens in first pregnancy about 2-4 weeks before the beginning of labor, but I may prove exceptional in this regard, too, and stretch it out longer or manage to wind up in labor sooner.
3. About the same time, I started having shooting pains in my right hip, along with the conviction that at the slightest provocation my hip would pop right off of my pelvis. Okay, so that's unlikely, but it sure feels like it when I stand up to discover that it is hip fun time.
4. I have this very urgent desire to do several things before the baby comes, such as going to a movie in a theater (which we did on Monday) and going to a baseball game for a local team (which we have yet to do). In short, I am wanting to do the things I think won't come easily in a month or so, and while I am afraid to buy tickets to anything in advance, if I feel up to a trip out to do anything fun, I've become quite spontaneous about doing it.
5. I've started nesting. I think I have done about 5 loads of laundry and a load of dishes today. I even rearranged some things downstairs to make room for the pack-n-play. This is unusual for pregnant me. Seriously.
6. I have started watching birth-related TV shows like there is no tomorrow. I then cry at every birth and watch another one a few minutes later. *sigh*
7. I'm still following the rules quite faithfully, but I am getting really tired of my gestational diabetes lifestyle and am counting down to the due date with all of the insane fervor of the ice-cream-deprived pregnant woman I am. I don't crave pickles and ice cream, but the ice cream alone would be such a marvelous indulgence... it makes me weepy to think about it!
8. I've graduated to OB visits every week.
In short, I'm fine... if a little worried that the hip issue will make me less mobile in a hurry and a tiny bit concerned about the prospect of preterm labor. I'm looking forward to my next OB appointment, since they will be checking my cervix. I have begun to wonder if I have any other physical signs of preparation for labor, and that will likely tell me about one of the most critical. My blood pressure is also creeping back up a little, so I will be keeping a close eye on that. I'm not feeling too anxious for it all to be over yet since it's really too early for the little guy to make his appearance and that knowledge tempers my enthusiasm, but I am looking forward to the next step in the journey and can see how I will probably ramp up my expectations as the days and weeks pass.
Baby seems to be fine, too. His heartrate is around 130 and he's measuring 1 cm large, which is exactly what he has been since they started measuring. That's a good sign, and that he's not growing any bigger than that may be part of the payoff for my lifestyle discipline. He seems to be a bit more cramped in there, but he can still manage to beat up my insides pretty well.
Yeah... we're looking forward to meeting him... but we can wait a few weeks! :)
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