Tag Archives: labor and delivery

Full term, and the end is in sight!

Hard to believe, but here I am at 39w1d — officially full term!  I just had what is looking like my last prenatal appointment this morning — one more NST and ultrasound, and then the midwife checked my cervix which is looking like it’s starting to do things (2cm, 60% effaced, medium, soft, and -1, for those who like the stats).

I’ve been talking about the possibility of induction with my providers for the past few weeks — my favorite doctor in the practice is on call next Friday, and L&D had openings, so we went ahead and scheduled an induction for next Friday.  I’m a little nervous about induction, but I’m more nervous about going too late and risking the complications that come with that.  I feel good about being induced at 40w2d — my dating is extremely precise (was tracking ovulation and had several ultrasounds around 6-8w that all agreed with ovulation) so there’s no chance of accidental prematurity, baby was measuring 76th %ile as of last week (bigger than my first son), and since my first son was born at 40w5d (after labor at 40w4d) and my cervix is already ripening I think the chances of my body not being ready for induction are pretty low.  I found some great statistics online, and with a Bishop score of 8 (or more by next week) and a previous vaginal delivery, it looks like my odds of needing a C-section with induction are about 6% or less.  Plus it’ll be good to have a date when I know I can stop taking the Lovenox — I just hope I don’t jump into spontaneous labor an hour after my dose sometime in the next week!  (I actually skipped it this morning, just in case the cervical exam got things moving — last pregnancy a doctor did a membrane sweep at 40w4d without warning me, and I had my first contractions within an hour after that appointment!)

It’s so hard to believe that by next week we’ll almost certainly be meeting our second son.  I mean actually hard to believe — it just doesn’t feel real yet, somehow.  We’re as ready as we can be, and now I’m just hoping for no surprises, no emergencies, and maybe even a similar textbook labor and delivery as we had with S.  It’s so helpful to have the memory of S’s birth to ground me — I feel much less fearful about going back to the labor and delivery ward of our local hospital than I did last time, when my only association with that place was the awful delivery of our daughter.  I now know that things can go well, and I even have an expectation that they might go well, rather than feeling like I’m constantly in emergency mode.  Part of me wonders if my more even-keeled emotional state in this pregnancy will affect the baby.  Maybe this baby will be more laid-back than his big brother?  We can hope!  (S was actually a pretty great newborn — he’s mostly just a bit more clingy and anxious than the average toddler, I think.  But if I got another like him, I’d be thrilled!)  Wish me luck!

 

37 weeks

Well, this is it.  37 weeks.  Officially early term.

I had my second NST + AFI with the local OB today, and everything is looking good.  Baby has finally flipped, so hooray for head-down!

Today I was pleasantly surprised to be seen by my favorite OB in the practice rather than the one I had been scheduled with — I think I’ve only seen her once early on in this pregnancy, but she’s the main doctor I saw during my pregnancy with S and she’s really the reason I came into the practice, so it was nice to reconnect with her.

She did ask me about how I was feeling about induction vs. waiting for spontaneous labor.  I told her I don’t want to go much past my due date, and she said that she understood and agreed and they’d be willing to induce me anytime at 39 weeks or beyond.

That was actually kind of reassuring to hear — I’m not into interventions, and I was really pleased to go into spontaneous labor one day before my scheduled induction date at 40+5 in my pregnancy with S.  But at the same time, I worry a lot about the small but rising risk of stillbirth after 39 weeks — for me, even though the probability is low, my experience with late loss tells me that I would not want to torture myself with wondering if I could have avoided it by inducing earlier if I ever did wind up in that situation.  In addition, the closer I get to my due date, the more stressful it is to have to worry every morning about whether or not I should inject myself with Lovenox (which I’m staying on right up until delivery thanks to the Heparin allergy we discovered in my pregnancy with S).  I was a huge fan of my epidural while delivering S, and I know I can’t get an epidural until 12 hours after my last dose of Lovenox, so if things start on their own and happen quickly I could end up with an unplanned, unmedicated vaginal delivery, which I am just not interested in (though I know and respect that many women are) — obviously I’d deal with it if it happened, but I also worry about what would happen if I ran into complications and had to have a c-section.  Without the option of an epidural or spinal, they’d have to put me under general anesthesia, and I both find general anesthesia pretty creepy and also would be sad to be unconscious for the birth of my son.  Induction offers a nice way to have a little more control over the timing of stopping my medication and not worrying about the small but real risk of developing clots.

So, the way I left it with her is that I’ll wait to see what my cervix is doing in a week or two, and we’ll take it from there.  As a multigravida who had a totally textbook vaginal delivery last time, the risk of c-section is pretty low this time, induction or not (especially given the results of the ARRIVE trial).  My plan at the moment is to aim for induction during the week of my due date, unless my cervix is totally unfavorable, in which case I’d wait until the next week (the end of week 40) to induce.  But I am not interested in the risks of going into week 41 and beyond, so if I haven’t gone into spontaneous labor by then I will stop caring what my cervix is doing.

And there it is.  Unbelievably, our baby could be three weeks away… or even less!  It’s thrilling and terrifying and unbelievable all at once.  I can’t wait to welcome him to the world.

Breech Watch

35 weeks today!  Hard to believe our new little guy will make his appearance in about a month!

Everything is still looking good, with one exception: he still hasn’t flipped to head-down, so we are officially on breech watch from here on out.  Last week the ultrasonographer at MFM told me he was breech, and today the local OB did a quick scan showing that he is transverse.  She said that if he really moved from breech to transverse on his own in the last week, she’s “very optimistic” that he’s still on the move and will flip on his own.  But if he’s still not cephalic next week, they’ll schedule a version for the following week.  It’s a bit complicated by the fact that he’s on the large side, still measuring around 80th percentile, so it’s not clear how much longer he’ll have room to move on his own.

I’m mostly managing to not freak out about this news.  I know that both late flippers and successful versions are more common if you’ve given birth before, so I’m hopeful that either he’ll flip on his own or a version will be successful.  Worst-case scenario (currently at about 25% probability, according to my reading) would be a scheduled c-section if he won’t flip.  While I’d love to avoid a c-section if possible, my perspective since the loss of our daughter has always been that whatever gets baby out as safely as possible — for both baby and mom — is the way to go, and if that’s a c-section (which it sounds like it is, thanks to the Term Breech Trial), so be it.  The idea of a c-section freaks me out quite a bit, and I can’t help but think wistfully of my super-easy recovery from S’s birth, but at least a scheduled section sounds less scary than an emergency section.

Otherwise, it has so far been my favorite kind of pregnancy: boring and uneventful.  I finished my hat-knitting project (I wound up knitting three sizes of hats just to make sure there’ll be something to fit each of two kids), and I’m looking forward to giving them to my sons (plural!  can you imagine?!) after the birth.  The nursery is in reasonable shape, all of S’s old clothes are washed and organized, S is going nuts waiting for Halloween, as well as being obsessed with the two new babies in his daycare (he almost cried when baby Jack wasn’t there this morning), and we’re just generally trying to get the last few things on our to-do list done.  Except for some rain, we’re having beautiful fall weather, and I’m mostly just trying to enjoy these last few precious weeks as a family of three before our lives get upended, hopefully in the most joyful possible way.

Early Days

IMG_0237We are so lucky.

Our son, Soren, is now three weeks old.  It simultaneously feels as if he’s been here forever, and also that he is this amazing and magical new creature of a human who can’t possibly be with us on this earth for real and forever.

I don’t want to minimize the very real difficulties of labor and delivery and life with a newborn, but so far (knocking crazily on wood as I say this) the start of his life feels charmed — it’s all gone as smoothly as I think it possibly could have.  The contrast with our first pregnancy is jarring, but having had that experience where everything went wrong has paved the way for me to appreciate how very right everything has gone so far this time around.

I hope I’ll find time to write up my birth story on the blog eventually, but the short version is that a membrane sweep sent me into labor the day before I was scheduled to be induced, and Soren was born the next day.  Since my water had broken and since I was positive for Group B Strep, they did have to augment my labor with Pitocin, but everything progressed smoothly despite the intervention.  Eventually I opted for an epidural, which is a decision I was immediately happy with, and after an hour and a half of pushing and some quick suctioning to get rid of his meconium-laced fluid, Soren was in my arms (while I sobbed tears of joy and relief).  I had two second-degree tears, which were stitched up quickly, and I was up and walking around only a few hours later.  Soren’s heart rate never faltered, he was born alert and latched on to my breast like it was the most natural thing in the world (and he’s hardly been off since!).  My milk was a bit slow coming in, but a few days later he was pooping and peeing like crazy and he’s been gaining almost a pound a week since then.

Amazingly, the recovery from this full-term delivery has been easier than the recovery from the delivery of my daughter at 4.5 months.  Two days after delivering my daughter I tried to go walking with my husband and our dog, and I was so dizzy that I had to sit by the side of the road until he could come pick me up in the car.  Two days after delivering our son, we all went for a long walk and it felt so good to stretch my legs.  I couldn’t believe it at first, but then I realized that last time around I didn’t know it yet, but I was dealing with both hemorrhaging from a retained placenta and a raging infection, not to mention the emotional impact of the loss of our daughter, whereas this time around everything was healthy and normal.  I didn’t even worry about whether or not I was healing normally, because I already knew what abnormal healing felt like.  This just felt a thousand times better.  And let me tell you, engorgement is SO much easier to deal with, both physically and emotionally, when you have an adorable baby to feed.  It wasn’t as painful and didn’t last as long, and I LOVE knowing that I am providing nourishment for my son — it made the (milder) soreness totally worthwhile.  Knowing how amazing I felt compared to the first time around — again, both physically and emotionally — just sent me into an emotional high those first few days after his birth.  Having a supportive husband and mom around helped too.  We decided that having three adults to care for one newborn was just about the right ratio!

And I know that putting this in writing is probably going to jinx me forever, but… I’m pretty sure we won the easy baby lottery.  No newborn is truly easy to live with, but we seem to have gotten it about as easy as it gets.  Sure, he fusses occasionally, but we can always calm him down with some combination of the 5 S’s (swaddling, swaying, shushing, sucking, side-lying).  And while we’ve had a few tough nights here and there, most of the time he sleeps in two- to four-hour chunks at night, and will wake for a diaper change and feed and then go straight back to sleep.  I keep waiting for the other shoe to drop — I’m convinced that there’s going to be some disaster, or he’ll get sick before six weeks and need a spinal tap and be up crying all night, or that he’s sleeping too much and it’s a sign of developmental delays to come, or he’ll suddenly get colicky in week four and we’ll be miserable for the next couple of months.  I guess this is just the beginning of a lifetime of parenting worries.  But in the meantime, I will enjoy this magical baby that we have been given!

After she went home, my mom commented to me about how healing it was for her to see everything going so well with my delivery and postpartum recovery.  She felt like it was healing for her as well as for me, since her experience giving birth and caring for me in the first weeks was also extremely difficult — she wound up with an emergency C-section, and I was colicky, and my dad was not supportive.  She’s seen a lot of deliveries since then in her work as a women’s health nurse practitioner, but it’s different when it’s your daughter, and when you stick around after the birth is over.  She said that watching me going through a healthy and normal delivery and recovery, and caring for a healthy newborn with a supportive partner showed her just how good things could be — how right it was possible for everything to go.  After being with me for the horrible end of my first pregnancy, she said it was so wonderful to see things finally going right and well and to see me finally getting to be a mother to a living baby as I’ve wanted to do for so long.  It really has been amazing, and I feel so extremely fortunate to be here at last.

This isn’t the end of our story.  I know there will be challenges ahead with Soren, and I know there will be challenges as we start to work towards conceiving our next baby (we very much want a younger sibling for Soren).  But these early days have been so very beautiful — yes, sleep deprived, and yes, full of the exquisite boredom and dull busy-ness of caring for a newborn… but also astonishing and full of truly momentous love and the incredible process of watching our son’s life unfold.  I feel that I will never tire of kissing his soft cheeks and watching his enormous blue eyes take in the world.

We are so very lucky.