Monday, August 29, 2011

Sitting Around Waiting To Go Into Labor...

No baby yet. I still hope to be posting a birth story soon. (Like, really soon? Maybe?)

I'm very happy to report that this pregnancy has been my "healthiest," in terms of weight gain and overall feelings of well-being. The very beginning was rough. I didn't have much morning sickness, but I had some other weird symptoms that were apparently hormonal, and I also had a lot of trouble with my sciatic nerve until the middle of the second trimester. However, I haven't gained nearly as much weight as I did in my first two pregnancies, and, in even better news, my blood pressure has been very stable! Every week now when I see my CNM, I wait anxiously for the blood pressure monitor to display my numbers, and every week I heave a great sigh of relief when the numbers are in the normal range once again. My biggest worry since the beginning of this pregnancy would be that I would have high blood pressure again and need to be induced or c-sectioned.

I am now 38 weeks, and delivery seems imminent. For almost two weeks, now, I've been having intermittent contractions, strong but relatively painless. I can feel that the baby is moving down, and when I told my CNM that I had showed up to the hospital dilated 4cm with my second son, she decided to check my dilation at my office visit just to see what was going on. As of Wednesday, I was 3cm dilated and 80% effaced, and she could just feel the baby's head! She swept my membranes, saying that if labor was on the verge of starting, doing so could get things going. And yet, here I am, five days later, still no baby. Amazing how pregnancy can fake you out even right at the end.

I wrote out a "birth plan" and then decided not to print it. I have just a few desires for this birth, the main one of which is "have a vaginal birth." My intention is to avoid all interventions (IV, Pitocin, epidural) not because I have any kind of "earth mama" thing going, not because I'm altruistic or hippy or crunchy, not because I have any kind of "I am woman, hear me roar" complex (I'm more likely to whimper than roar), but because, to be honest, I'm more afraid of the drugs than I am of the pain of labor. Now that I know as much as I do about how interventions can negatively affect the birth outcome and the health of the mother and baby, I'm afraid of them.

I know this sounds a bit silly. I've had Pitocin and epidural with both previous deliveries. How can I now be afraid of them, when I consented to them before?

Well.

My first birth did not go at all as I'd hoped, ending in a rather unfortunate c-section as it did. I went into that birth wholly uninformed about what epidurals and Pitocin really do. My second birth went phenomenally well, but even so, I avoided the epidural as long as I could because I knew being mobile might be key to having the VBAC I wanted. As for the Pitocin in that second birth, when they present to you your option of "have a stroke or give birth right now," it's sort of a no-brainer.

So why am I so afraid now? Well, I learned that the use of Pitocin is linked to increased risk of both postpartum hemorrhage in the mother and jaundice in the baby. Both of my sons were jaundiced enough to require home phototherapy, and both births resulted in postpartum hemorrhage for me. I don't think it's unreasonable to want to avoid Pitocin, knowing that! And I'm more likely to avoid Pitocin and get the baby out more easily if I also avoid an epidural, which would require me to spend the rest of the labor on my back, which I'm really not that interested in doing. I figure I'll play it by ear, though.

This time, my blood pressure is steady, my weight gain is good, the baby seems to be average size (I've been measuring right on target for fundal height, at least), and everything is progressing normally. I get to have a spontaneous labor, and I'm GBS (group B strep) negative, which means they won't require IV antibiotics during labor, which means I get to choose, well, pretty much everything. Having so much choice, in a way, is scary. I admit that part of me was hoping my blood pressure would spike and they'd tell me they had to induce (a very very small part of me, of course). Part of me was hoping that when she did that internal check and swept my membranes, labor would start. The biggest part of me, certainly, keeps reminding the rest of me that "He'll come when he's ready" and "Don't be in such a hurry." Really, I'm just uncomfortable.

I think what gets me is the uncertainty. I've been so sure, every evening, that tonight will be the night. And then it isn't. But surely tomorrow? No? I keep reminding myself that I haven't even reached my due date, but when you've been having contractions for almost two weeks, the due date starts to seem a little irrelevant. Why won't the contractions build into labor?

Because?

Because either the baby or my body just isn't quite ready. I'd venture to say my body is quite ready, which leads me to believe the baby has just a little more growing to do. And I want to let him do that.

Did you know that in the last few weeks, the lungs and brain are still developing? That's why medically unnecessary scheduled inductions and c-sections before 39 weeks are not recommended. In fact, some hospitals are banning them. Babies born between 37 and 39 weeks are being called "late-term preemies," and quite a few beds in the NICU are taken up by these babies who were born, unnecessarily, before they were quite ready.

So I'll stick it out a bit longer. I'll be 39 weeks on Wednesday, and then I'll have a serious talk with the little guy inside, because, really, I'm kind of tired of all this almost-labor business. I've reached a point where when I sit on the toilet, I'm sure I'll go to wipe and find his head crowning. In some ways, that's pretty cool. In other ways, well... My preferred hospital is 45 minutes away, and I'd like a little warning before the whole crowning thing!

So, here's hoping my next post will be a birth story. In the meantime, anyone else out there who's almost in labor, like me, hang in there! We won't be pregnant forever, and a week isn't really that long.

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