Wednesday, April 23, 2008

The New Plan

So, after much anticipation, I had my "36 week" appointment today and was able to discuss my ultrasound results (although she hadn't reviewed them) and our alternatives and plans for delivery. I must say I am very happy with my doctor because she took all the time we needed to discuss and even though this was a fairly routine appointment, she didn't make us feel rushed at all.

She really does not want me delivering a huge baby. She discussed how as an OB she can handle switching to c-sections for things like fetal distress or failure to progress, etc., but one of the scariest things is a severe shoulder dystocia. If the baby is half way out and gets stuck, it's pretty hard to do a c-section. She said in that case that have to get the head back in and take him the other way (OUCH!). Although, Graces labor and even first part of delivery was fairly easy, they don't want to chance that I have a 10 pound baby.

She can't do anything at the moment because I'm just shy of 36 weeks and you aren't considered full term until 37 weeks. Also, she isn't allowed to do an "elective" induction earlier than 39 weeks without proving lung development. So the options are:
1) Once I complete 37 weeks (3/3) she could order an amnio to check on the lung development. If they are developed, we would be cleared to induce. Some possible complications of an amnio are rupture of membranes or beginning labor. Neither of these are major concerns because that is what we are working towards anyway. She also told me at this time they wouldn't try to stop labor anyway.
2) We pick a cut-off date (closer to 39 weeks) and if I don't spontaneously go into labor by that date, we would do a c-section. A c-section could still be required anyway (the longer we wait). If she sees signs during labor that things are stalling or slowing, it may be a sign that he is too big and they might still decide to do the c-section. Again, more likely the longer we wait.

I would prefer not to have a c-section. They won't induce me if his lungs aren't ready, so I don't see any real risk in pushing the delivery up, so we decided for now to go with Option 1. We also told her that our most important objective is a safe and healthy baby, so while I prefer not to be cut open, if at any point she recommends that as a better option, we'll go with the flow. No arguments from us.

I got a call this afternoon telling me that they are scheduling the amnio on Tuesday, May 6 at 1:00 p.m . If the lungs are good (test results only take about an hour), we would induce on Wednesday, May 7th (37weeks, 4 days). That is two weeks from today. They can't officially schedule at the hospital until 1 week prior, so they'll do that next week and I should know by the time I have my 37 week appointment next week.

After this entire discussion, she decides she should probably check me and I have my internal exam. I am currently 2 cm dialated and 70% effaced. So, nature is getting the process started. Maybe I won't make it two more weeks. Just to give you an idea, at 36 weeks with Grace I was 1 cm and 60% effaced. I also made it 3 more days after my doctor's appointment that I was 3 cm and 90% effaced with Grace, so that doesn't mean I'm necessarily going into labor in the very near future.

I stayed late at work tonight on got the big project done that has been hanging over my head. I really think if I didn't go back, the world wouldn't end. Sure I've still got stuff to do, but I'm not stressing.

Probably stupid to even mention it, but I've been extremely uncomfortable all evening and am just resting and timing my contractions now. Someone at work got me all paranoid by mentioning "loose stools" as a sign of labor. I've been having issues for a couple days now. Oh well, I'll be done in two weeks or less. We'll just see what happens.

2 comments:

Lisa said...

Hmm, baby Luke just might be coming on his own....

You're in my thoughts! I'll be checking in daily now!

Crystal said...

The morning I woke up with mild contractions with Leon I did end up having several bm's that day. I guess it was my body's way of "cleaning itself out" before the actual delivery got there. Followed by that was the bloody show and then a few hours later, very strong contractions. Every pregnancy is different though. C-sections aren't that bad. I was terrified of having one, and now I'll be having another one. It wouldn't be my first choice, but right now for the 2nd baby, I really have no choice with us living so far away from the hospital. I recovered very quickly. When they let you get up after the first 24 hours, I literally walked the floors on my own, did whatever I wanted and never even flinched. I really never took pain meds either...I'm just hoping this one is as easy! Good luck, I can't wait to see what happens. It's so exciting!!