Tag Archives: epidural

How to be supportive of women’s birthing choices

*Note: throughout I got tired of writing ‘women and their partners and families’, so I just wrote ‘women’. But I do believe wholeheartedly that birth decisions affect the whole family, and so should be a somewhat group decision.

Ah, the Mummy wars. Just as we might be close to reaching some kind of rapprochement over one issue (breastfeeding), we really hammer into a new one: birth. For the unenlightened, a war is indeed brewing. On one extreme, you have the group who think that any intervention is ‘birth rape’ (not kidding…). On the other side, perhaps as a backlash, you have the women claiming that allowing any kind of pain in childbirth is anti-feminist, and women who don’t give birth in a hospital are baby killers. It’s just another incarnation of the nipple waving breastfeeding sluts vs. the poisoning lazy formula feeders debate.

It would be nice if we could just ignore this. Let the extremists be extreme, and live in a happy middle road. But the knock on effect is that women are becoming miserable – people feel judged and found wanting, guilty, denied a right, some even feel violated for a medical professional doing their best. While I support attempts to improve medical care, and thus women’s birthing experiences, this does not seem the right way to go about it. I understand that is hard when people think they are fighting risk to babies, or denial of rights to women – both highly passionate issues – but it seems to me that the path we are going down is not working. Families and caregivers need to unite in support of one and another to enable informed choices and happiness with those. That’s not the same as inaction, nor will it lead to stagnation. I believe that within this modus operandi, there is still room for encouraging change and I also believe it is the way to help women and their partners make better choice.

Here is how I try to be supportive of all birthing choices:

(1) Everyone: Be realistic and scientific.

Don’t lie. Home birthers: admit that the risks to mother and child are higher (but very small) and note openly that scientific evidence shows that epidurals at the right time do not increase C-section rates. Hospital birthers: be open: yes, a C-section is more likely, even when other factors are controlled for. Yes, pitocin increases the likelihood one will want an epidural, and not due to this, also increases the likelihood of a C-section. Be honest: you are more in the doctor’s hands, and you may be pressured to make an alternative choice. Home birthers: women in hospital may also not be pressured to make choices against their will and may work with professionals who are incredibly dedicated to following their birth wishes.

I have seen both done. At my Bradley classes (a natural birth class), our instructor was having a home birth. In the discussion about risks and benefits she noted that the risk were higher, but in absolute terms extremely minimal. She told us to go away, read, and make our own decisions. When my OB told me I needed an induction and I was resistant, she honestly talked through the increase in C-section occurrence. She told me to go away, think and read, and make my own decision.

Only by talking through openly and honestly about the facts and figures can women* make informed choices, and research ways to mitigate unwanted outcomes. When my OB was open about the increase in C-section risk with pitocin, I was able to research how to deal with this, and constructed a careful plan which took 2 days to effect, but resulted in a vaginal birth.

beliefs

(2) Anti-home birthers: Accept that you cannot save all of the babies, all of the time.

It can be a very emotive subject, and anti-home birthers usually cite the well-documented and reliable statistics of increased mortality with home birth. It is a tiny increase, but the pleading ‘won’t you please think of the children’, often accompanied by a picture of a stillbirth, can be very compelling. But here is the thing: home birth is not the last bastion of child (or maternal) risk. Children are starving to death, being shot to death in war, being shot to death because of lax safety, dying of vaccine preventable diseases, dying of non preventable diseases, dying because the basic standard of medical care is not uniformly distributed across economic strata in the US. That’s not to say that we should be cavalier about infant mortality, but some perspective helps. If you are not pouring equal amount of vocal outrage into all causes of child suffering (especially given how many more children die from these other causes, than from home birth), I would ask you to reconsider your reasons for championing an anti-home stance.

(3) Home birthers: to use your own words: anyone could do it.

If forced to, then I am pretty sure (but have not checked the empirical evidence) that anyone could deal with the pain of childbirth. Some people choose to have an epidural (or other pain relief) and there is nothing ‘weak’ about it. It’s just a choice, like the one to go to Kroger vs. Fiesta (or Tesco vs. Sainsburys for my dear UK readers), and should not have a value judgement attached to it.

(4) Anti-home birthers: We all take risks with our child.

Accept it, we all take unnecessary risks with our child. To anyone taking a ‘holier than thou’ approach to their child rearing I could point out preventable risks you take. Take your child in a car? Increased risk!! Why not stay at home or within walking distance until the child is 16 ?  You might say: that’s not practical, the benefit outweighs the unrealistic cost.

Sure – to *you*. There are people, I am sure, who follow this (small number though they are).  Ultimately: you don’t know the cost to someone of going into hospital. You don’t know their fears and needs, and how strong they are. You cannot judge for someone else whether the costs outweigh the benefits, because you don’t know them.

(4) Home birthers: We all take risks with our child.

You may tout increased bonding for a drug free childbirth, or a cite the evidence that some aspects of pain relief get to the baby and affect their immediate post-birth presentation. But again, you will do something that is sub optimal for your child’s development (although defining that is tricky), sometimes out of ignorance (and so some education is OK), but sometimes because to you and your family judge the benefit to be greater than the cost, as above. And that’s OK.

I could go on, but it has been (for me) a long post. I will always choose a hospital birth. I will always research and learn, but I will always reach an agreement with my trained medical professional. If I can’t do that, I will seek out a medical professional with whom I can, because this provider is obviously not right for me. For my birth, I agreed to an unwanted induction, but I worked out a fairly long and complicated plan for doing everything I could to ensure a vaginal birth. Indeed, this was necessary, if I had not worked with my OB on devising a 2-day induction, I would have been one of the ‘C-sections after a day on pit’ statistics.

That being said, if I had had a C-section, I hope I would have worked with my provider and still have thought it a wonderful experience. Many aspects of my birth sucked (or at least the aftermath), but I am delighted with the whole experience. Shit happens. But I got this thing out of it:

P1000780

My plea: chill, relax, channel your energy / outrage somewhere else [send refugees donations, volunteer at your local hospital, whatever], remember that you are not a bat, and don’t know what it is like to be a bat. Gain some perspective: birth is important, but it is just one aspect of a whole lifetime of wonderful experiences.

Peace. Love. Babies.

 

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Samuel’s Birth Story

This is the story of how Samuel Clarke Frazier came into the world 🙂 It ends at that joyous moment, so there is no dwelling or rehashing of the difficult time that followed – just a history of the moments leading up to one of the happiest points in my life. However, it is a birth story. It is graphic. On other blogs I have seen the authors put up birth stories and readers complain that words like ‘cervix’ and ‘discharge’ spoiled their breakfast. Well… expect that and more, if you stick with this post, you may know me VERY well by the end (although note: it is safe for work, and suitable for my students to read and still respect me afterwards).

We left off when the hospital had called. I had been merrily distracted by an awesome ‘shower in a box’ but as soon as the phone rang, all the emotions hit me: fear (perhaps terror), panic, excitement. At that moment, all I could think was ‘I am not ready… I just need another day…’. I answered the call, and the nurse told me that the hospital was not sure they could fit me in that day after all – but she would call and let me know later if it was a possibility. She could call us, but if we had not heard by 9, we could call her.

Ugh. Talk about a mood changer. OK, I might not have felt ‘ready’ but I did not want to delay this. I cried, so Wes got me out of the house to a gorgeous little Italian in Bellaire (where I ate about 3 bites of pizza and boxed the rest) and we got ‘Rock of Ages’ on DVD to distract ourselves. 9 came… no phone call, and at 9.00 and 1 second I dialed the hospital. Come on in they said! Come in for 11. Woo-hoo. That was a difficult hour to kill, but we changed and packed and tidied and faffed and left ridiculously early.

We got to the hospital at 10.50 and were not turned away! This was it… it was happening! Then began wait after wait… waiting for a room, waiting for a nurse, waiting for the cervadil (I am not complaining, I utterly accept that on a labor ward, the woman NOT in labor is the least of their priorities)… the upshot was, it was 2 am (yawn) before the induction began.

Induction part 1: Friday night: Cervadil.

Induction of labor

Waiting for the first stage

Cervadil is a gel they put on your cervix overnight, to ‘ripen’ it (nice terminology, always reminded of ‘the reaping’ in The Hunger Games). Hopefully it thins the cervix and dilates it, meaning the pitocin has less to do – some women respond so well they go into labor, but that is not the purpose per se. The cervadil basically looks like a long tampon, but a doctor has to insert it (boo). Unfortunately, my doctor (the resident for that night) was very heavy handed – placing it and then pushing, and shoving more. I did get quite bruised, from the heavy-handed insertion, otherwise it would have been utterly painless. Once it was in, it was painless (I couldn’t feel it at all) and time for lights out.

Cervadil in, and no discomfort

Many hospitals give a sleeping pill at this stage, but I was not offered one (I don’t know if this is because my OB practice is as hands-off / anti-interference as possible, or because I had told them that minimal intervention was my choice) and I did not want one. Slept like a log anyway, until I was woken up at about 6 to see how it had worked.

Bed for the husband in hospital with labor

Wes’ cot

I was pleased to see my OB, Dr. Boswell, in the morning. We love her, and she did the examination to see how the cervadil had worked. The result? No effacement, no dilation. Nothing. No change. Boo. I was disheartened, but Dr. Boswell was upbeat and said it was just time to start phase 2: round 1 of pitocin.

Stage 2: Saturday morning: Round 1 of pitocin

IV for pictocin

IV line for the pitocin

The turned the pitocin on at about 9. As I had wanted to try to labor without an epidural (even on pitocin) they started, as promised, at the very lowest dose: a 2. I waited, with some fear, for the hugely painful contractions pitocin is supposed to give, but… nothing. So after 30 mins, they upped it to a 4. And I waited… and nothing… this carried on all day, until at 2 pm Dr Boswell came back. She asked how I was feeling, and I gave a very merry “Wonderful! I feel great!” but her response was “Rats. I was hoping you would be in a lot of pain by now”. She didn’t think the pitocin was working – we could see my uterus contracting on the monitor, but no nice rhythmic contractions, nothing that seemed productive. And no pain meant that clearly, nothing was really happening. I asked if getting up and walking would help, but she said, not at this stage. I was welcome to, but resting for actual labor might be better.

So… I waited… and waited.. and we upped the dose every 30-60 mins. When the dose was at a 12 (not very high, it goes up to 20), at about 7 pm, Dr Boswell recommended the pitocin be turned off. You could see that my uterus was contracting constantly, with no break in between, but I could not feel it. I was still spending my time reading, watching TV, texting, Skyping my Mum. Basically: completely ineffective contractions. They checked my cervix: no effacement, maybe a fingertip dilation. Again: basically zilch.

Here, I am very grateful to have been with The Women’s Specialists of Houston. Not only did the doctor leave me alone all day (very few internal examinations… in fact, just one, with an intern who again was extremely heavy handed until she bought tears to my eyes) but many doctor’s would have just upped and upped the pitocin, labelled it a ‘failed induction’ and gone for the C-section. Dr Boswell said that this can occur for a number of reasons and that the game was not up yet. She said that nerves / tiredness / stress / hunger (I had not been allowed to eat before being admitted) can cause pitocin to fail: she wanted me to have a relaxing evening, with a big meal, and a good sleep. She also said that pitocin causes the cells that trigger contractions in response to pitocin to be expressed on the wall of the uterus, therefore they can work better on a second attempt, but you need a rest so your uterus doesn’t get ‘exhausted’ (yes… really). So, feeling doomed to failure I agreed to take a break. At this stage, I began to feel quite depressed about the whole thing: I had really wanted as natural of a labor as possible, and this felt anything but. My body just felt like a passive vessel for medical intervention: I felt nothing, I felt my body was doing nothing. Still, when Dr. Boswell suggested one last intervention to help tomorrow’s pitocin: a foley balloon, I agreed to try it to help avoid a C-section.

Stage 3: Saturday pm: Foley Balloon

A foley balloon is another method of helping dilation, but it is mechanical rather than pharmaceutical. Basically, they insert two balloons into you, one in your uterus between the baby’s head and your cervix, one just outside the uterus resting on the cervix. They fill the balloons with water and hope the pressure mimics the pressure of a baby’s head descending in labor, and so causes your cervix to dilate. Bleugh. I will say, Dr Boswell absolutely gave me the choice of having the balloon or not. She also sad that she would stop at any point when it was uncomfortable, and if we could not fill the balloons with the recommended amount of water without discomfort – we just wouldn’t. She saw no point in discomfort, nor wearing me out more. She is awesome.

The insertion was about as pleasant as it sounds – luckily Dr Boswell is a wonder at doing these procedures and it was just unpleasant / uncomfortable more than anything. At least, that was the physical side, emotionally I felt a bit like I was sick of being prodded and poked and my body not being my own. But hey ho. Dr Boswell saw all my bruising from the heavy handed intern examinations and offered me ice, which was nice, and sympathy, which I think was nicer 🙂

But once it was in, actually, no problem. I could not feel it at all, and ended up like this moments later:

Foley Balloon not hindering sleep.

It was weird getting up and going to the bathroom with it in… but otherwise, it really didn’t bother me.

At 6 am (why so early?? Why??) Dr Boswell (phew) came to remove the foley balloon. It was simple and painless – she drained the water and it kinda slipped out. Moment of truth time: had it done anything? Had it made any difference?? YES! I was 4 cm dilated! This is the stage they will often admit you to hospital (if you are not being induced), and evidence that my body might actually respond to something.

Stage 4: Saturday am, Pitocin round 2

Nice day to have a baby?

So, we were all go on the pitocin. They worked the same way as before: starting low and increasing the dose until it was effective, but not letting it get so high my uterus got exhausted (for real… they actually said this… hence the need for an overnight break and some food). Dr. Boswell came to wish us goodbye 😦 So sad to see her go, but she handed us over to her colleague Dr. Dryden with promises that she was ‘wonderful’ and ‘very experienced’ and had delivered both of Dr. Boswell’s babies. Dr Boswell said not to start the pitocin until the change of nurses shift at 9, so that the nurse can monitor the whole reaction of my uterus, and see it’s responses and patterns. She warned me that the time was probably coming to break my waters, she emphasized that given all the excess fluid, no one, but no one was to break my water except Dr. Dryden, in case of a prolapse. Then Dr. Boswell left for some much needed sleep (she had been at the hospital all Saturday and on call all Saturday night).

Waiting… waiting… by the time the nurses had switched and done their rounds, the pitocin was started at 10… again, I could not feel much, although it did feel a little bit more like rhythmic menstrual cramps. Dr. Dryden came in at 10.30 and determined it was time to break the water. I liked Dr Dryden (and she did a wonderful, wonderful job at the birth and after) but she was quite different to Dr. Boswell – I felt everything was an option and my choice with Dr B.; with Dr. Dryden felt more that things were going to be done her way. But I did like her and felt quite comfortable around her – plus she did the most wonderful job of the actual delivery so am eternally grateful for that. I got a bit antsy when she mentioned breaking my waters – we had been taught in Bradley that this increases the risk of C-section because once your water is broken, if the baby was not out in 24 hours, it was an automatic C-section. Wes asked if this was the case and Dr. D said ‘No, you are absolutely not on any clock’ so we agreed – again, I have a feeling that was going to happen anyway 😉

Dr. D. pronounced me still 4 centimeters and broke my waters. It took all of 2 seconds, I didn’t feel it at all, and then there was just a horrible hot gush. Ugh. Dr. D left, the nurse upped the pit and left Wes and I were left to our own devices. Before the nurse left she mentioned again that she could give me wireless monitoring so I could get up and walk – AS REQUESTED IN MY BIRTH PLAN – but you know when you are in pain and all you want to do is curl up and laze around? Yeah, I was there. All I will say is that breaking the waters is darn effective. Immediately, I began to feel contractions. Painful, but spaced out. I practiced my Bradley relaxation techniques to get through them – they came about every 2 minutes. Whether they are more painful than non-pit contractions I will never know, but I will say that you do get thrown straight into later stages of labor – for example, straight into 2 mins apart, painful contractions, which is often not the case with natural labor.

At about 11, the nurse came in and told me that she had read my birth plan and was here to get me walking. I wasn’t really given a choice, but in a good way. I had given them detailed reasons why I wanted to walk and use the birthing ball (pain relief, good positioning, speeding up labor) so the nurse played hard ball and made Wes walk me up and down the corridors. Again, a highly effective way to get labor kicked up a notch. The contractions got more painful and about a minute apart. Again, although painful, it was bearable as I could get a complete pain-break as these photos taken 30 sec apart show:

Labor contraction

Contraction


Break from contraction 😉

I tried the birthing ball, which pre-labor I was convinced would be the best place for me. It hurt more, hurt my tailbone and I practically kicked the thing out of the room. I also, with Wes’ help, tried squatting, which was equally as miserable. Walking it was.

Then I needed the loo. No. 2. Wes told me I would have to buzz for a nurse, but I didn’t see why. I buzzed and the nurse said “wait! Wait for me’ which I tried to do, but she was ages coming. Ages. I was in pain, in labor and I needed to go. I tried to wait, but eventually, I figured I would either go on the floor or in the loo, so I might as well use the loo.

Waiting for the nurse so I could use the loo! Gave up and used it anyway, much to her chagrin.

The nurse busted in while I was going (see? Labor is just so not dignified – and yes, I was with it enough to be horribly embarrassed) and chastized me. She told me that needing the loo was often a sign that the baby was coming and she was cross I might have had the baby in the loo. What was I supposed to do? Holding it was not an option!! She had to come quicker if she wanted me to wait! So, she wanted an exam afterwards to see if the baby was coming. So – at 11.15 what amazing progress had I made? 4 cm, maybe 4.5. UGH. Back to labor.

When the nurse left, the contractions got really bad. They just didn’t stop one on top of another. The pain was bad (but I could cope with it):

Ow. Ow. Ow.

Then I needed the loo again. Really, like upset tummy needed to go. I buzzed for the nurse and waited and waited and buzzed and begged them to come (I was close to going anyway, but torn between my discomfort and being told off again!), when she came she wanted me to use a bedpan! No freakin’ way! Gross. So, I pointed out that just a few minutes ago I had been 4.5 at most and so really, no baby was going to be falling out of me. She agreed and let me use the bathroom (although she insisted on being in there with me! When I had an upset tummy! Told you: labor is not dignified).

While in there, I had a mental breakdown. The pain was horrific, and I was not progressing. I could deal with this pain, but given that I was dilating 1 cm every 2 hours, and had 5.5 cm to go – not for another 11 hours. Plus, if this was early labor, how bad would transition be? F that, I’ll take the pain relief. So, I asked for the epidural.

It was administered quickly (within 5 mins) and within 10 I had gone from this:

Ow. Ow. Ow.

To this:

Bliss.

As soon as the epidural had kicked in – about 11.45 the nurse wanted an exam, so they could ascertain in the future whether the epi had caused me to stall. I was annoyed: what was the point? I had been at 4.5 forever, and so finding out I was 5 was not going to help. I acquiesced, a resident Dr was called, and I grumpily let her announce that I was “9.5, maybe more, there was just a lip, and the baby was coming NOW”.

What? What the F-ing F? Some 40 hours to get get 4 cm, then to 9.5 in 40 minutes? So looking back, this:

Ow. Ow. Ow.

was transition. We had been taught in Bradley that transition was the most painful time, and the time the women find it most emotionally difficult and cry for the epidural. Our plan had been for Wes to step in at that stage and talk me out of it.. however, we just had no idea we were in transition. We thought it was too soon. I was annoyed that I had an epidural so late: I was moments away from giving birth when I got it, and most of the hard stuff had been done. I could have had a non-epidural (one can hardly call all the cervadil, balloons and pit natural…) birth, but hey ho. While I was annoyed that we had managed this slightly wrong, I was also pleased that I was enjoying this last stage. Plus, most of my fears about an epidural were unfounded: I could feel my legs, I could use my legs and I could certainly feel the contractions.

The nurse took a picture of us as a 2-some, promising to take the same picture but with the baby between us, when he was out (we never got this latter picture as everything went a bit Pete Tong, but hey ho)

Last picture as a 2-some

Doctors were called, and it was time to push. I declined the mirror and pushed – again, the epidural did not affect my ability to push as I could certainly feel quite a lot. I could tell the nurse when my contractions were coming, and she often had to help me hold off on pushing the urge was so strong, so that I could let the pressure build. Pushing went pretty well, Firework moved quickly – so quickly, they had to chase him with the little monitors.

After about 30-40 mins we could see the head, then poor old FW got stuck 😦 I had been warned about a very narrow pelvis and nothing seemed to get him past it. We tried squat bars, different positions, breaks, laboring down, I even let them get the dratted mirror. After 2 hours of pushing, they called Dr. D. She watched a few contractions and coached me. I actually said “It is OK to use forceps if you need, or cut me” but she didn’t think we needed that yet. She put her hands inside me (owww… just owwww… the epidural seemed to be doing F all at this stage) and said that FW was a slight transverse – he was facing the wrong way (up, not down – ah back labor also explains the yell for the epidural earlier) and slightly sideways. Again, I am grateful I was with the Women’s Specialists, many OB’s would have gone for an emergency C-section at this stage. Not Dr. D. Mindful of my ‘no C-section if possible’ [and now it does seem silly I was so adamant about that] scrawled all over my birth plan, she just turned him manually while he was inside me.

That. Is. The. Most. Pain. I. Have. Ever. Experienced. I swore violently – then apologized. But Dr. D was doing absolutely the right thing, using each contraction and push to slowly stretch me and rotate FW. I began to worry that FW was in danger as his heart rate was dropping, but Dr. D was wonderfully calm. I even said “if you need to do a C-section, do it!” but she said “I don’t need to see him now. I do need to see him soon, but he is OK now” and quietly called some extra pediatricians in. Once Dr D had figured out he was the wrong way and stuck in my weird pelvis it was all quick quick. Another 30 mins or so of pushing, with her help, and my beautiful boy was born:

He was handed straight to me:

and taken off for some checks as he had been stuck for quite a while. All the checks were done in the room, and Wes got to help, although he mostly took photos:

FW had become Sam! The long pushing didn’t affect him at all. He took a while to cry which freaked me out (I got slightly panicked over that) but his apgar scores were 8 and 9 and his lungs, when he decided to use them, were certainly powerful enough 🙂

Sam was little enough that I only had a minor second degree tear which Dr D and an intern stitched up, while Sam was assessed. Sadly, as I was quite ill, I didn’t get Sam back after that 😦 But, that is not this story. This is the story of how the lovely Samuel Clarke Frazier came into the world at 16.32 on November 4th 2012, weighing 6 lb and 15 oz. A wonderful, wonderful day:

39 weeks (nearly) and preparing for birth

37 week bump

37 weeks 2 days

Well, hello 39 weeks. And now we have a date, I know I really am in the home stretch. Firstly a big, big thank you to everyone’s support after my last pregnancy update, given in the comments or on Facebook. When I wrote 2 weeks ago, I was very sad about not being pregnant for much longer. Many people were kind enough to write and say ‘I felt the same’ and even – ‘now I am a Mommy I STILL feel the same!’. Everyone adored their babies, but it looks like I would not be the only person to choose the baby and the belly if I could.

37 week bump

37 weeks 2 days

Hearing ‘you are normal’ or ‘your feelings are valid’ made a huge difference. Yes, I remain sad that I have – maximum – 5 more days left to be pregnant (more on that later). But I am much more cheerful knowing that feeling like that is fairly common, and a wonderful life ahead still awaits. I haven’t really addressed the issue further, except in one small way. Mostly, I just chose to be comforted by so many people’s kind words, but I have done a little positive visualization / positive list making about what I am looking forward to about the baby coming. Both have perked me up considerably.

38 week bump

38 weeks 5 days

The other thing I have done, is address my mental issues with the birth a little. I had hoped for a natural childbirth. I was going to fight to go over 42 weeks, if necessary. I wanted to go into labor naturally, to labor naturally, and to birth naturally, if possible. The reason why is not so important (come on, this is the girl who chose Tough Mudder – I like a challenge 😉 ), but do know that I recognize natural childbirth as my personal choice – as much for my benefit as the baby’s. Very much ‘each to their own’ and this was my chosen own. However, it looks like things will not go that way. The polydramnios situation is not getting better 😦

38 week bump

38 weeks 6 days. Trying to make it stick out more!

What does this mean? Well, my fluid levels at 25-30 weeks were in the 95th-98th percentile, generally 25-28, but mostly around 25. Average AFI (amniotic fluid index) is 10-14 (dependent on week), and cut-offs for ‘high-risk’can be 20, they can be 25, depending on the country, hospital, person etc. So, I was just on that borderline or just at ‘worrying’ – as Dr Dildy, the high-risk OB put it “You’re not off the charts… you’re just not on a very good position on the charts”. Dr. Dildy said some places would not consider me high-risk, if their cut-off was 25, but Baylor (where he practices) is a little more conservative so does. However, more in a ‘needs to be monitored’ way than a ‘holy crap’ way. So.. they did just that. Monitored me and watched the baby closely with weekly biophysical profiles and all looked pretty good. Plus, we scored cute face pics from our very friendly sonographer. Those who know me well, how much to do recognize the expression below? What Clio calls my locking horns, digging hooves in expression.

37 week 4D scan

Ha! He may look like his father, but he has his Mum’s obstinate expression down to a tee! (37 weeks).

The problem came later on. Usually people’s fluid decreases, starting at around 30 weeks, going from an average of 14 to about 8-9 at 37 weeks. Mine did not decrease at all, it stayed stubbornly at 25. So, as the bell-shaped curve shifted more and more the the left, but my position stayed the same, I was more and more of an outlier. So, technically, I became more and more high-risk. I chatted to no less than 3 OBs (the one I didn’t like, Dr. Dildy who I really do like, and my OB whom I love). I did proper research (i.e. hit up PubMed and read real research papers, not just Google). And I ended up agreeing, of my own volition, that going past 40 weeks was associated with significantly higher risk. Significantly. My OB was actually happy to wait right up until 40 (some would have pushed for an induction at 38-39), so it seemed a good situation, because I felt she was trying to accommodate me and the baby and not just ‘get things done’. Induction is booked for 39 weeks and 5 days from today.

I am still scared of a cord prolapse. Because of all the fluid, the baby doesn’t want to fully settle deep into the pelvis, head down – there is a little gap between his head and the.. er… exit. When my water does break there is likely to be a lot of force to it, both because there is nearly 3 times the usual amount, and because it is under a lot of pressure (think of an overfilled balloon). So, it could force the cord out before the baby, the baby’s head would fall down into it, and the baby’s oxygen would be cut off. In hospital, this would just mean an instant and emergency C-section. If it is before hospital… well… we hope I get there pretty quick. The chances are just under 10% statistically (they are under 1% of you have a normal amount of fluid) so non trivial. But, hence, we hope that I won’t go into labor before the induction, and if I do, at the first sign of labor, rather that waiting at home until I am in ‘active labor’ I am to go straight to hospital. I am as at peace with this plan as I can be.

38 week scan 4D

Sleeping peacefully at 38 weeks. This baby is photographed more than Suri Cruise 😉

So, in a nutshell, I have had to prepare for a different kind of birth. That’s OK, but I am someone who likes to be in control of what is happening to my body, and my baby, and generally my life. I am rarely good at handing over large aspects of my life to others and saying ‘OK, do what you will, I will go with the flow’. It tends to leave me in a cold sweat. If I have ever said to you ‘sure, I’ll come over and you can decide what we do / what we eat’ you know I like and trust you a lot 😉 So, I have been preparing (for preparing is calming) for other plans.

I have tried to strengthen my uterus to be good at labor, in a situation where it may not be ideally ready: evening primrose oil, raspberry leaf capsules, dates. I have tried to help the baby prepare my uterus / get into a good position when HE may not be fully ready: bouncing on a birthing ball, squatting 20 mins a day, walking. I have been rehearsing birthing techniques for withstanding an epidural because pitocin may lead to a more painful labor than a natural labor (pitocin contractions MAY be stronger and harder, and pitocin, unlike its natural form oxytocin, does not cross the blood-brain barrier and give pain relief).

I am also preparing to be accepting of an epidural: the hard part of labor may be longer and if I need more strength, an epidural may help me conserve my strength. I am preparing not to resist the epidural just to be bloody minded – mainly I just want to resist it to the point where it will not slow down labor. And, I am preparing to accept a C-section with grace (the risk is doubled with an induction), and not feel disappointed, or like I failed, or miserable about it. Just to be grateful that it is an option in this day and age!

Oh, and I am packing my hospital bags! I finally did it last week. For me, 2 bags. One for labor containing snacks, gatorade (YUCK), hairbands, warm socks, snacks, my birth plan, protein shots (old habits die hard), a bikini. Snacks…

All encased in my new diaper bag:

And then for ‘postpartum’, hair & make-up stuff (WHAT? My Mum allowed no cameras into the room until her hair and make-up were done! Seriously!), pads, comfy clothes, reading materials, chargers (phone and iPad) and nipple cream / pads (snigger):

A ‘going home outfit for me (YES I AM GOING TO WEAR HEELS IF IT ISN’T A C-SECTION DAMMIT):

And best, best, best of all. For Firework, a ‘first day’ outfit (a little tiger one) and his going home outfit (Alabama T-shirt and shorts like his Daddy wears) + a random onesie ‘just in case’.

All ensconced in an old gym bag. We also have a much coveted and finally obtained Aden + Anais swaddle blanket, a nursing pillow (coz I just love my boppy) and a going home blanket with little racoons on, given to me by my mentor at work. Of course, these bags are packed for a dash to hospital and a regular birth. If we have an induction, we go in at 8 pm for a special gel, stay overnight, start pitocin at 7 am and keep it going for as long as I and the baby can take without distress (which could be 36 hours, but is likely less). So.. then I won’t have two separate bags. We’ll be less birth focused and more focused on just entertaining ourselves in hospital. If it gets to the day we’ll throw in some puzzle books and more entertainment.

Pretty exciting really.