MFM appointment this morning revealed that Tiny is still tiny but still doing well by most measures: adequate fluid, good blood flow in the umbilical cord, moving well, practicing breathing, with an excellent heart rate. The placenta is showing slightly more signs of dysfunction, but is still working effectively. For now, it’s stay the course.
For those who are newer to the Gayby Project (and a refresher for those longtime readers who don’t recall the extensive birth stories of all the bloggers you read . . .) – I was induced with Ansel at 37w due to sudden onset pre-eclampsia (basically, I went in for my appointment at 36w3d with swelling in my legs so severe I couldn’t pull my pants up, was summarily sent to the triage and given a pre-E diagnosis and then scheduled for induction just a few days later.
I felt very strongly about having a vaginal birth. I read Henci Goer and absolutely did not want ANY intervention if possible. But I had pre-eclampsia (initially fairly mild, getting worse steadily) and so induction needed to happen. God bless the midwives at the hospital where I delivered, who did everything in their power to get me that vaginal birth. I did countless rounds of cytotec to ripen the cervix, had a foley bulb placed, spent hours walking and bouncing, had pit drips on an off, more cytotec . . .each day something closer to labor would happen, but it took 4 days before I was actually in labor. And then I spent 8 hours in excruciating Pitocin driven contractions and never progressed past 6 cm. I made a decision after 5 full days of induction to have a cesarean section. Ansel was born with a double nuchal cord (why he wouldn’t descend) and was in the NICU briefly. I would never have had a vaginal birth. But I got a gold medal in trying.
L does not feel strongly about how she delivers Tiny. She never has. Other than getting him safely to this side of her body, she’s not attached to the process. She also witnessed my extensive induction and knows well that 37w inductions, statistically speaking, are less successful. We have also been told that IUGR babies tend to have more trouble withstanding vaginal delivery, especially induced labor (because of the intensity of the contractions.) All of this led us to a conversation about the possibility of an elective c-section.
On Monday, the regular OB (I’m gonna start calling him Dr. Rambo Claus because he has a Santaesque beard and face, but he’s also hella ripped, which is weirdly disorienting.) mentioned their typical process for induction, which sounded about like mine – cytotec, foley bulb, Pitocin. L had to sign ‘consent to deliver’ forms and she signed both the vaginal and c-section forms since things are so up in the air. He mentioned at that point that we could, at any point, decide to elect a section.
We asked the MFM about it today, and he explained in even more depth (two side notes: 1) we both like the MFM SO MUCH MORE – he’s just more engaged, better at explaining things, warmer, altogether just a better doc and 2) he’s SO SHORT, like probably 5’3”? or 5’4”? which I always feel weird about because I’m so much taller – but I’m going to name him Dr. Lilleput) that the induction would be VERY limited – if L wasn’t in labor (not delivered, just in some sort of active labor) within 24 hours of starting induction, they would likely opt for a cesarean. And, if at any point Tiny or L showed signs of distress, they’d stop induction and opt for a section.
This definitely eased some of the anxiety, but I think it’s still something we are thinking of . . .so, I’m asking for input – what would you do in this situation?
Of course, there’s also other things to consider this time around. 2 ½ years ago, it was possible for both L and I to be in a hospital for 5 days having an induction. We had a dog sitter and very little else in the way of obligations. Now we have a toddler and almost no community to call on for help. We do have friends (who are now between 30-60 minutes away, depending on the time of day and the whims of Seattle traffic) who can help us out in a pinch, and L’s mom will be back as soon as she humanly can once the process gets going, but I’d be lying if I didn’t say the ability to know the timeline of a c-section wasn’t also tipping the scales.
FREE REIGN TO GIVE ADVICE (just be nice about it, ok?)
Sweet Eliot dog seems to be doing well on pain meds and the follow up with the vet felt MUCH less intense. The regular vet did a very extensive neuro exam to look into the slipped disc issue and found no evidence of anything concerning. He has some pronounced arthritis in his hip and knee, but she actually thinks the neck thing was more likely a soft tissue injury (ie: he sprained his neck really bad) but has recommended keeping him on pain meds for at least the next month. I feel immense relief that he is not on death’s doorstep (and am more than a little peeved at the emergency vet who kind of implied otherwise.)
I’m sure the updates will be more frequently as we roll towards August 12th. Dr. Lilleput said today we were “circling the airport” – seems like an apt metaphor.