Holding Steady

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?)

 

Other updates:

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.

2017072695122347
Half Tiny’s cute face/ half placenta he uses as a pillow
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9 thoughts on “Holding Steady

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  1. It sounds like L and Tiny are in AWESOME hands. I would, personally, probably go in for a scheduled cesarean under the same circumstances, knowing how difficult induction is at 37 weeks. Here would be my ideal path forward:
    1) Have cervical position and measurements taken at 36 weeks, then at 37 weeks. If and only if I was already in a good position (low and forward) would I consider an induction.
    2) If in the right position, attempt induction. Having a 24 hour timeline would make that feel more manageable for me at 37 weeks. If it didn’t get going, I wouldn’t want to keep pushing it.
    3) If not “ready” to go into labor easily, go with the cesarean.

    This comes from talking with friends who have had emergency cesareans vs scheduled. Scheduled seems to be far less stressful for everyone, and you’re less exhausted with the new baby. There are new techniques for doing cesareans that can mimic vaginal birth better now. If that’s important, I can send you some info on it that I was reading a few weeks ago.

    Good luck!!!!

    1. I was going to vote the exact same way! Consider looking up “seeding” if you go c-section…helping the baby get some of the good bacteria and develop a healthy microbiome from mom’s vagina even though baby exits through abdomen.

      1. My vote goes this route too. I still mourn not getting to deliver Azulito but if IUGR was in play and a risk of pre-e, that would be it for me. Hands down. But you know i am super risk averse in this part of my life after all I’ve been through, not to mention my knowledge of delivery tragedies from when I did med malpractice defence. So take my view with as many grains of whatever seasoning suits!

        That said I’m so glad Tiny is chugging along and so is L. Sending all of you heaps of all the best woo.

  2. I was successfully induced at 37 weeks for pre eclampsia. I was nowhere near natural labor, and from insertion of cytotec to delivery was 28 hours, she was just over 5lbs so was a small little thing. So, it’s possible. I don’t think trying the induction would hurt anything, sounds like your doc won’t let anything drag on for days once the ball starts rolling anyway. I’d go for it if for no other reason than having a chance at an easier recovery time.

    1. ^ This would probably be my decision. It gives L a chance to go more natural and likely have an easier recovery and if it doesn’t work, it doesn’t work, no harm done. It helps immensely that she isn’t attached to any particular type of delivery. I can’t believe it’s getting so close to meeting Tiny!

  3. Well obviously my position is biased. I’ve never had an induction though so I can’t even give input there but my options this birth were given as induction or section. Obviously due to different reasons than yours mainly large backwards eyebrow first babies. I can tell you that having limited family support during Abe’s pregnancy I had two sitter options and both fell through while I was in labor and it was stupid stressful. Obviously with induction you do have a narrowed down timeline to organize childcare but for me a huge plus is having a set date and time now for childcare. Ancedotally I’ve heard better recoveries after elective sections vs sections after a failed induction and so I didn’t want to chance laboring and needing to have a section anyway. I also like knowing I can go calmly into the process for me this pregnancy has been really insane and stressful since the beginning and I see this as some small control I’m gaining back. I’m sorry that wasn’t very helpful and mostly about me

  4. My wife has been induced two times, both very successfully, although both were 7-9 days overdue, and neither had any lingering medical wrinkles behind them, so I’d say that’s probably not very helpful information to base my opinion.

    But we have had five kids, two requiring NICU stays, and having to juggle who watches them is by far the worst aspect and largest stress inducing concern and that includes delivering the baby. I would say I’d heavily favor ANY scenario that makes all aspects of delivery easier, including the rest of the family who needs care, whatever you decide that option to be, keeping in mind recovery on both ends as well.

    (My sister has six – six!- cesareans and every single recovery was different. Just seeing that in mind.)

    And, of course, even though we had overly planned for The Viscounts delivery, we had NOT planned for an extended NICU stay, so things happen, best laid plans, blah blah. I know you know this, and I know WE knew this, but we honestly didn’t even think to plan for it, even though it was so obviously a possibility.

    Wow, that was useless, huh? I think I just repeated what you said. This is not my best comment.

    Either way, I don’t think you all could make a wrong decision, so probably just whip out the old pros/cons list and tally it up. Problem solved! You’re welcome. 😉

  5. I know I’m a bit late to the party but my baby had IUGR as well, measuring between 1st and 3rd percentile from 30 weeks on. She was 0th percentile at birth all around. I was induced at 37 weeks (1cm dilated and 80% effaced and only needed the foley balloon before starting pitocin) and we were successful although it took longer than 24 hours. My point is that you can be successful with an induced vaginal birth for IUGR. Another blogger (Great Pudding Club Hunt) was as well. But honestly it sounds like your MFM is fabulous and has both L’s and Tiny’s best interests at heart so whichever way you guys go will be good. Good luck!!

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the snearses

some vegetables, some cats

The MD & Me

~ my not so glamorous but oh so blessed life ~

Star In Her Eye

raising a rare girl

Mama et Maman

A blog about two moms trying to conceive

Becoming Mommy and Mama

Two ladies on a baby adventure

YoungIVFerChantelle

My journey to get my Miracle.

single ma in siberia

a single Australian queer's TTC quest/ parenthood journey

babamimi

"Your family needs a reality TV show"

Our Egg, Her Nest?

My journey to Motherhood through gestational surrogacy

Raising Race Conscious Children

a resource for talking about race with young children

Three Hearts Beating

Two lesbian mamas make some queer spawn...

Papa Bear

how two boys made a baby

midwestmammas

lesbian, parenting, ttc, lgbt, baby

and baby makes 3

two moms and a new baby

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