Saturday, January 24, 2009

40w4d: And Waiting...

No, no, I'm still here and still pregnant...

Here are some updates:

From Tuesday, 1/20/09 (40w0d):

I actually went to work today (my due date) because, well, I couldn't see any real reason not to do so. (Tuesday is one of my days working at the VA, and I only have ~3-4 weeks of paid leave (accumulated sick leave and vacation time), so I decided that I might as well go there, work a little, and not use up my precious sick leave/vacation time. I am feeling more ambivalent about going to my other work site tomorrow. It is more stressful. Still, there is the issue of taking leave now versus later, and the other issue of not being paid for my entire maternity leave anyway. We'll see!

I truly have nothing new to report. Occasional B-H contractions, none involving my back. Really no extra "pressure" to speak of, no mucus plug, nothing. I just feel bigger and bigger but nothing is happening. I sometimes wonder if this baby is even in my pelvis at all. I woke up 3 times overnight to use the bathroom, but during the day it seems like I am waiting for hours with no problem (even less of a problem than a few weeks ago). Argh! My biggest fear at this point is getting induced sometime next week, failing to progress, and then getting a C-section that I don't really need. I'm trying to take it day by day and trying to distract myself.

From Thursday, 1/22/09 (40w2d):

I just got back from my OB/GYN appt. I'm currently 40w2d, with essentially zero progress over the past 2 weeks (1 cm, 50-60% effaced, soft, -3 station). So disappointing!

From what I've read, induction of labor is not very successful in women with numbers like these (especially primigravidas, or first time preggos, like myself). Lots of info out there on the so called "Bishop Score." I specifically asked my OB/GYN about that, and she seemed to think that induction would be successful (but I'm not sure why). She said that my score would be pretty good. By my own calculation, my score is 3, which is actually in the group most likely to end up getting a C-section.

The plan is to induce me on Sunday night (40w5d) with hopes of me having the baby on ~Monday at 40w6d. I asked about the method of induction (Cervidil, prostaglandins, Pitocin, or whatever) and my OB/GYN said that they would use a Foley catheter inserted into my cervix to start dilation. She said that oftentimes they do this, labor starts, and they don't even need Pitocin.

I had never heard of this induction method before and wonder if anyone has first-hand experience. So far, my friend tells me that one of her friends had this done and it was very uncomfortable. I *HATE* having a Foley in my bladder, so I cannot really imagine how it is going to feel having that thing in my cervix. Online (google), people who had it done seemed to say that it was not too uncomfortable. I did some searching on google and pubmed, and it sounds like this is a low-tech way to start labor, is used worldwide, but for some reason is just starting to catch on here in the US.

I have to admit that I started crying a little bit after we discussed the induction. I want this to happen on its own SO badly. But at the same time, I don't want to wait past 41 weeks and beyond.

After my appointment, I had an NST and everything looks great with the baby. The placenta has some minor signs of being "older" but nothing unexpected. My amniotic fluid index is 13 point-something, so better than last time (9).

I'm going to do everything possible between now and then in hopes of something happening on its own.

From today, Saturday, 1/24/08 (40w4d):

Yesterday (Friday, 1/23/08) was my birthday (34!), so my thought that maybe the BabyGirl and I would share a bday did not come true. However, I finally took a day off from work and officially started maternity leave.

I ran a bunch of errands. I checked out two Ina May Gaskin/midwifery books from the library. Even though I am not going that route, I think it is interesting and hopefully I'll enjoy reading positive birth stories during my labor.

I spontaneously made a last-minute acupuncture appointment to see if that could add anything. I have done acupuncture exactly once before, on the day before my embryo transfer for IVF. This same woman says that she has experience in inducing labor, too. Anyway, I thought I would be there 30-45 minutes, but the session ended up lasting a little over 2 hours (!).

The acupuncturist first put needles in the webs between my thumb and index finger, in my supraclavicular fossa area (between neck and shoulder), and in several spots on my inner leg (above ankle, inner calf, and lower/inner thigh). She lit a charcoal/herb stick and moved it around in front of my belly and also my legs. It was warm, and it felt good.

She then put an electrode-type thing on several of the needles and turned it up to the point where it made my muscles twitch just a tiny bit. and said that the baby would probably start being really active. She left me there for probably ~40 minutes in near-darkness, with nice relaxing music. I was mostly just lying quietly and relaxing, but I dozed a bit and was awake at certain times, too. BabyGirl, instead of getting super active, seemed to snooze almost the entire time.

The acupuncturist then returned to the room and had me role on my side. She put some needles on my lower back and again placed the electrodes again. BabyGirl woke up a bit more and was moving some, but nothing extreme. Around this time, I realized that a buzzing sound that I had been hearing intermittantly was not "some weird machine in the next room," but either my pager or cell phone going off. This did kill the mood a bit, but I tried to just ignore it.

Finally, the acupuncturist returned again and placed some glass cups on my back (moxibustion/cupping). Again, only minor movements from the BabyGirl. Personally, I think that the fact that I hadn't eaten lunch before my 1:30 appointment had a lot to do with her relatively quiet state. Like I mentioned earlier, I had no idea that I would be there for over 2 hours!

For dinner, I went with my mom, dad, sister and S to my favorite Thai restaurant. I asked them to make the spiciest dish even spicier. I also asked the owner (my mom kinda knows her as we've been going to this restaurant for ~15 years) if there were any specific Thai foods rumored to induce labor. She didn't know of any, unfortunately.

Later, S and I came home and got busy... (It had been TOO long...both of our faults, I suppose)... Well, that felt great actually, but it didn't really seem to set off any major contractions, either. Waaah. This AM, I woke up feeling a little achy in my pelvis, kinda like when I have my period. However, there is no contraction-y aspect to this feeling.

This morning, I saw that someone replied to my post about Foley catheter inductions on the Ovusoft Labor/Delivery/Post-Partum forum. This poster is a Bradley method instructor, so knowledgeable about birth, but obviously on the lower intervention side of things. Anyway, she suggested that I will be at higher risk of cord prolapse during an induction because of BabyGirl's -3 station. Ugh! How terrifying!! I hadn't even thought of that.

She also said that she would assume that they are planning to break my water if the Foley catheter alone doesn't work to start labor. (She guessed that on her own, but yes, my OB/GYN did mention that possibility.) Finally, she also suggests that I am putting myself at a high risk of C-section, which was also my previous concern. Argh!

I talked about all of this with S. Right now, I think I am going ahead with planning for induction Sunday night. (Of course, I am really REALLY hoping that I might make progress before then.) Maybe BabyGirl can at least move down a little bit more? My Bishop score would improve a lot (and risk of C-section would decrease) if she would at least move down to -2 or -1 station. Anyway, I'll plan to go in to the hospital Sunday night, as planned, but before absolutely commiting to the induction, I'll ask the attending MD there to check me out and tell me my current dilation, effacement, and station. Then, I am going to try to get their honest opinion about the risks involved with waiting for this to happen naturally versus induction. I will make it very clear that we are not pushing for either decision. We just want to do the best thing for BabyGirl, and if that is truly a toss-up, also for me.


ashley said...

Oh my, you poor woman. My sister was always past her due date with all three of her babies and she was definitely uncomfortable. I have no advice because I haven't been in your situation but I guess, just try your best to do all the "home rememdies" that htey say will induce labor. I pray this baby comes before they have to induce for you.

sarah23 said...

The weird thing is that I'm not even really uncomfortable (or just very minorly uncomfortable). I think it's because she is not very low in my pelvis.

alison said...

Ugh, I'm so, so sorry. :( Hoping you and baby girl are all safe and sound 48 hours from now.

I've not heard of the catheter thing for induction - our hospital/my ob will do cytotec in the evening (the pill goes on the cervix directly to soften and dilate it - though my ob said her colleague gives it orally instead, weird) and then pitocin the next morning.

Good luck with the induction!!