And now

6 07 2011

We’re still waiting. Tricked you there didn’t I? Though I was introducing the inmate.

We’ve had a AFI, NST which have indicated the inmates health is A-OK. I’ve had my second cervical sweep, 3 meals of spicy Thai (containing the critical thai basil), hiked mountains, had sex, and bounced on an exercise ball – nothing! I swear PLS’s WeeTwo or Dr.Isis Baby Isis are going to make arrivals before mine does.  I had an awesome appointment with my midwife, who assuaged all the fears that my lovely parents put into. What you ask? Your parents made you worry? Yeah I know that exactly what you do to an overdue woman, call her up and tell her how stressed you are about her overdue baby and how you completely disagree with her medical decisions about her body.  Yep thats really showing how much you care. Because you’re co-works, with dipolma’s in office administration really know more about deliverying a baby than your PhD candidate daughter, midwife with a 4 year degree in birthing babies and a OB/GyN.  Don’t worry, I’ve decided to no longer answer their calls.

Being the nerd that I am, I’ve been reading alot of the primary literature on inductions vs expectant management. The problem is that they’re mostly epidemiological studies and I have a very poor understanding of stats. Their appears to be a controversy about one the largest studies done. Where some researchers feel the wrong stats and parameters were used.  I have no way of analyzing the criticisms.  I’ve had people say to me that women have birthed for millennium without inductions, blah blah. While part of me agrees with that and prefers to keep the medical interventions to a minimum, I’m also a scientist who knows that for a millennium mothers have being dying during childbirth because shit goes wrong.  I am thankful for the advances that have happened in maternal care.

In speaking with the midwife I learned that there is no medical necessity to have an induction until 43 weeks if the AFI’s and the NSTs indicate a healthy baby. However the rate of still births goes from 1/1000 to 2/1000 after 41 weeks. I know 0.1% vs 0.2% is not a huge change, but if I have to choose between a c-section and a dead baby, guess who’s winning? The other thing I learned is the probability of a C-section is not as high as I thought. Up until a few years ago, women were given Picotin right away, regardless of how ripened their cervix was, which researchers believe led to an increased risk of c-sections because doctors were essentially forcing contractions when the body wasn’t ready.  Now the cervix is examined prior to induction and if it is not ripened enough, the mom is given a vaginal insertion when contains prostraglandins. These ripen the cervix and can lead to the onset of labor on their own. Only once the cervix is suitably softened is the Picotin given.  The midwife is pretty confident that if I’m induced, I will not have a c-section because my cervix is ripening, albeit slowly. Its come down from where it was last week and is very flexible. I’m a healthy individual who’s body is ready to give birth so the odds are in my favor vs say someone who has to have an induction because of a health issue (ie maternal BP, fetal vitals signs etc) and who’s body isn’t ready.

By regulations, I have to meet with an OB/GyN when I hit 42 weeks. The midwife emphasized that regardless of what the Ob says, the decision is always mine to make. Its my body, my child.  But its not that simple. Its not just my child. Mr.SM has to be comfortable as well. The increased still born rate worries him. He’s worried that the longer I  carry the baby, the more tired and run down I’m going to get as I’m getting HUGE. Day by day I’m getting bigger and so is inmate. We’ve made the decision that if I haven’t gone into labor by the time I hit 42 weeks, we’ll have the induction. Mr.SM is just not comfortable with waiting longer and its his child as well so lets all send labor inducing thoughts my way. I”m trying verbena tea today but am refusing the castor oil, oh and acupuncture! I know, I know, but desperate times call for desperate measures!

The shitty thing about the induction is that my entire labor will be in the hospital. I really wanted to stay home as long as possible.  At home, I have a large comfy bed,  a tub to soak in, soft lighting, food of my choice. But such is life……..

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15 responses

6 07 2011
Zee

I just wanted to say that at 41 weeks my cervix was chemically ‘ripened’ and I went into labor naturally after that point. No pitocin, no c-section, so it is totally possible that will happen to you as well. Good luck!

6 07 2011
ScientistMother

thanks zee! I won’t be having my cervix ripened, as it already is so unless my uterus decides to get moving on its own, picotin it is. But ca la vie:)

6 07 2011
stpetersburgmidwife

I’ve noticed that when my mama’s make the appointment for their induction…they almost always go into labor on their own the night before! Ha, I love this little caveat!

6 07 2011
DrLizzyMoore

Good luck! However the inmate arrives, it will be eventFUL ;). Oh how creative our little babies are at coming into the world!

6 07 2011
Rebecca Weinberg

Not too long ago, I saw Sue Carter talk about oxytocin. (*such* a great speaker, by-the-by). Anyway, based on the basic research (i.e. animal studies), I’d wager there’s a pretty good chance you’ll change the bonding-capacities of inmate for life if you do the pitocin. And it’ll be in the direction of *more* bonding-prone, as long as it’s just the pitocin and no epidural. That is probably not bad.
Given that, there’s some speculation as to whether it might lower the risk of autism.

PLUS, if you’re at a hospital in the US (don’t know about Canada) they tend to give you pitocin AFTER birth whether it’s necessary or not (it’s good for reducing rates of hemmoraging!).

If I’d known during Roo’s birth what I know now, I’d have been less reluctant to accept medical interventions generally, and a *lot* less worried about pitocin specifically.

6 07 2011
chall

Good luck and if nothing else, it sounds like you have managed to not be too stressed or nervous about this overdue… And I think it sounds reasonable to make the decisions on what both you and Mr SM feel comfortable with.

All the best!!

(as for the baby liking Kei$a… I dunno, haven’t really heard her 😉 )

6 07 2011
GMP

Re pitocin and no epidural that becca mentioned above: with my first, I was slow to progress, so after some 12 hours of labor they gave me pitocin and it was contractions non-stop, one right after the other, no breaks (the doctor was really pushing for pitocin, but that’s another story…). After several hours on pitocin and still not progressing (baby showing signs of distress, c-section was around the corner), I gave up and got an epidural, as I really could not stand it any longer and the baby needed out soon. Once the pain subsided, I progressed quickly and delivered vaginally. Bottom line — sometimes if you are in too much pain it can hinder labor.

What I am trying to say don’t dismiss anything a priori, people have different experiences. Your goal is a healthy baby and mom first, and presumably a minimally invasive delivery (a distant?) second. And I second hearing that a lot of time, once moms schedule inductions, they deliver on their own they day before!

On a different note, a wise friend of mine said “Savor it while he/she is still inside” — meaning, all hell breaks loose once the inmate comes, so maybe try to use this extra time to give a super extra overload of snuggles to Monkey. It’s been about 10 days since my baby was born, and I miss spending time with my older boys so much!

Good luck!

6 07 2011
ScientistMother

St.PtbgMid – thanks!
Dr.Lizzy – I’m just hoping its not as eventful as last time
Becca – I am by no means opposed to medical intervention. I am opposed to UNnecessary interventions that I have an issue with. With monkey I had to be given picotin and epidural to use the vacuum. The midwife tried to encourage me to try the picotin first before scheduling the vacuum, maybe it would’ve been fine maybe I would’ve still needed assistance. Either way I’m happy it wasn’t a C-section. I have no issues with necessary C-sections, they save the lives of both moms and infants. Unfortunately, there has been a rise in the number of unnecessary C-sections bc the baby the doc’s dont want to wait. And that is what I don’t want. I’m much more comfortable getting induced knowing that my probability of vaginal birth is still high. If I have to have a C-section I will.

GMP – you’re totally right about enjoying the time with monkey. I am 100%, but its hard in the sense I can’t just take him to the science museam etc bc I’m scared to go too far from home. I

6 07 2011
FrauTech

It’s funny but you know how it feels like all the women in your office get pregnant at the same time? I feel like all the women in the blogosphere are all pregnant at the same time. Good thing I haven’t seen childbirth or childcare negatively impacting anyone’s blogging productivity, I mean what’s really important here…anyways wishing you a safe (and soon!) birth.

6 07 2011
DMB

Sounds like you are calm, collected and making well informed decisions. Good luck and I can’t wait to hear about inmate’s arrival!

6 07 2011
Isis the Scientist

That’s how I went. About 48 hours before my induction the contractions started.

6 07 2011
ScientistMother

GMP – sorry commented got eaten by parents. Yep totally enjoying time with monkey. I also am not ruling anything out a priori, again I strong believe in the benefits of modern medicine, but some practitioners will give unnecessary interventions, whether that being a C-section bc they need to get somewhere else or a surgery because they don’t understand the full extent of a person condition (my grandfather). I would like the medical interventions be necessary , with the risks understood.

Frautech – haha! my blogging productivity hasn’t been very high. Its hard to impact negatively, something that is already low! 🙂

DMB – thanks!

Isis – lets hope!

6 07 2011
ecogeofemme

I hope it happens soon!

7 07 2011
Cath@VWXYNot?

Shall we have another argument about transit funding and gas taxes? Would that help trigger labour? 😉

Thinking of you and hoping things get started soon.

7 07 2011
ScienceGirl

I’d like to second what GMP said: I was in so much pain for hours of pitocin, making no progress and trying to not get an epi. Then once i ‘caved’ I was finally able to relax and baby was born soon after. Oh, and my induction was scheduled at my due-date appointment for the 42-week mark, and the 2-week notice didn’t matter to a certain little someone 🙂

Best of luck whatever happens. With an induction you would miss the opportunity to progress at your own pace at home, and would probably be in more pain, but the end result is the same – healthy baby! Go SM!

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