A bump in the road

Update: I wrote this on Tuesday August 10th.  We had another appointment yesterday that went much better.  However, one way or another, the baby is coming by Friday.

Shannon was 41 weeks on Monday.  For those who don’t know (and I was one of them at the beginning of this journey), the doctors start counting weeks pregnant from the date of the end of the woman’s last menstrual cycle.  (Sorry, Shannon, now everyone knows).  “Typical” gestation is forty weeks.  Anything past this is considered past due.  If you are 37-40, you are considered term.  Any earlier delivery usually results in a stay at the Newborn Intensive Care Unit (NICU) where Shannon used to work.  Any later, well that’s where things get interesting.

At 38 weeks, one of our doctor’s started talking to us about induction.  I guess we hadn’t been clear enough up to that point, but Shannon is a huge advocate of natural child birth.  Bring this stuff up to her and you can get an increasingly impassioned speech on modern medicine’s predilections for having a controlled outcome.  She will talk about our doctors  treating birth as a disease compared to other countries’ approaches.  Weirdly, the rise in interventions in our country has led directly or indirectly to higher mortality rates.  I dream this argument, I’ve heard it so much.  Needless to say, Shannon doesn’t want to be induced.

We went to our appointment yesterday with mixed feelings.  We have to go to an OB/GYN center in Wilmington because there is no birthing center here.  The doctors we see are trained surgeons and are very intervention minded.  In their defense, I hear their insurance and liability rates are enormous.  We were told by the wonderful Karin Walker in our natural childbirth class we may have to advocate and negotiate for a natural birth.  We had to bargain a little to get the appointment moved from this past Friday to Monday much to the chagrin of the front staff of the office.   The doctors we have spoken too haven’t been very encouraging of this process, but the nurse practitioner has been great.  We were worried our appointment Monday would result in the office scheduling us for induction later in the week.

The appointment was scheduled to be a three part appointment.  First up was the ultrasound to measure for amniotic fluid.  The tech who conducted the ultrasound was very nice and encouraging.  She said she measured 5 cm’s of fluid, and while that was a little on the low side, it was totally acceptable for being a week overdue.

Then we went to the non-stress test.  Basically they monitor the baby’s movements and heartbeat for about 20 minutes.  When the baby moves, its heart rate should rise.  They are also looking to see if the mother has any contractions.  Well our baby was moving a lot at the beginning of the test.  As Shannon and I sat there, we got more and more tired.  The hum of the machine and the rhythm of the baby’s heart made us both wishing for a nap.  Apparently, the kid wanted one too, because it appeared to fall asleep and leave us with a nice, consistent heart rate.  The nurse came in and said as much and brought Shannon some orange juice to drink to try and wake the kid up.   Mostly, the nurse wasn’t in the room.  At the beginning, when she was putting the monitor on Shannon she was complaining about how busy her day was going to be under her breath.  When the orange juice didn’t achieve its desired effects, she opened the door and sarcastically said “great” and walked back out.

The third part of our appointment started immediately when the doctor walked into the room.  He said, barring a couple of tests at the hospital, we would need to be induced this very day.  He was worried for the baby’s outcome citing low fluid and a non reactive stress test.  Shannon was upset.  Later, I was upset.  We felt marginalized and confused.  The tech said the fluid was fine.  The baby was moving actively at the beginning of the test and again once Shannon got upset.  Shannon remarked later that someone crying over an induction must be an unusual experience for them.  It was hard for us, because we dreamt of this happening a specific way.  We were sent home to pack our things and go to the hospital.

Once we arrived home, Shannon called Karin for some advice.  After hearing about our experience, Karin confirmed we weren’t crazy and that we could still advocate for ourselves.  She left Shannon with these words (paraphrasing), “Continue to ask for testing and negotiating, but don’t let them put in the IV before any of this happens.  If they put the IV in, you’re committed to an induction.”

Feeling emboldened by Karin’s words and some lemonade from Chick-fil-a, we went to the hospital with the mindset of having more tests.  When the first nurse read our orders, she said we were only scheduled for an induction, not any further testing.  She asked us, “You know why your here, right?  Do you know what this number means?”  She was dismissive but we held strong in our desire to talk to the attending physician first before going forward.  Once the doctor arrived, he was very nice.  We reiterated our intention to have a natural birth and asked if we could proceed in a different way.  He said, if it was his child, he would go ahead and have the induction, but that didn’t mean he was right.  He offered to order a bio-medical check on the baby to double check the fluids.  We said thanks and went to have another ultrasound.  We agreed before hand that if there was less than 8 cms of fluid, we would be induced, but if there was 8 or more, we would advocate to go home.

The ultrasound tech and nurse were amazing.  They found at least 8.5 cms of fluid in the sac and said repeatedly “your baby looks great! Go home.”  We felt so relieved and went home with a strong desire to get this labor going as soon as possible.  We have pulled out all the stops, mall walking, breast pumps and ridiculously spicy thai food.  We lived to fight another day.  With another doctor’s appointment Wednesday, I think we are going to need to get this going soon.

Until then.

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