So last night in birth class, we spent a little time talking about perspective-taking around labor. Specifically, we were talking about some of the thoughts shared by a visiting couple who came to share their birth story. The mom had a low-lying placenta throughout her pregnancy, which pretty much guarantees that you'll get a c-section because there's a high risk of placenta previa which is just no good at all. So, a drug-free birth is then not an option. But then just a week before her due date, a sonogram revealed that her placenta had moved and she would be allowed to labor after all. She said that she was just so grateful to have the privilege of even trying to labor naturally.
Grateful for labor.
It changes a person's take on labor when you're grateful for the opportunity to try it - for the chance to see what you can do.
I think I needed that message last night. Because this morning I had my 30-week appointment and I left feeling not so great. My pregnancy has really been good. I have vomited all across the Eastern half of the country, but still my nausea hasn't been as bad as some experience. And nausea is something I can manage alright. My health and Baby B's health haven't been in danger. I've gained 6 pounds total, so I'm not gaining too much which was one of my fears going in to the whole thing. I've measured exactly where I need to be at every appointment (fundal height measurement). Baby B's heartrate has been in the normal range. I don't have gestational diabetes... things have just gone really well. But then today, they tell me that because I have a history of chronic hypertension, I will not be permitted to go past 40 weeks gestation. I will need an ultrasound every month from now to 36 weeks, and then one weekly from 36 weeks to delivery. I will need two non-stress tests each week starting at 36 weeks. The concern is that my history of chronic hypertension could be prohibiting enough blood and oxygen from reaching the baby, causing premature aging and inadequate growth.
To which I say... WAIT A MINUTE HERE. I asked about induction weeks ago and you said that your policy is not to induce before 42 weeks, provided things look good. No mention of this sudden 40 week induction deadline.
Actually, I just sat there. I only asked two questions. One - does this induction thing apply even if my blood pressure is fine at 40 weeks (as it has been throughout my entire pregnancy - below 120/80 at every single appointment)? The answer was yes. And two - you're saying I'll have three appointments per week, one of them at UNC (awful awful parking situation), every week from 36 weeks to delivery? The answer was yes.
So I let the midwife check the baby's growth (30 centimeters and I'm at 30 weeks) and heartrate (150s) and position (vertical) and movement (she could see Baby B dancing around while she was taking the heartrate). And I left and called Jonathan to fill him in. He was planning to come today but we agreed that he wouldn't because he has to miss some work tomorrow afternoon for our meeting with the mortgage lender. And Jonathan had a bunch of questions, like why didn't they inform us of this policy, say, IN JUNE WHEN THEY KNEW I HAD HYPERTENSION FOR HEAVEN'S SAKE THEY'RE THE ONES WHO HAVE HELPED ME MANAGE IT AND I EXPLICITLY ASKED THEM IF IT WAS OKAY FOR ME TO BE A PATIENT THERE AND HOW THAT WOULD WORK AND... Jonathan was a bit upset. I was still processing everything but he had jumped ahead to frustration. I soon joined him there. He promised to come to my sonogram next week and appointment at the Birth Center the following week, where we'll be prepared with lots and lots of questions and at least one clear brain for asking them between the two of us.
In the end, we want a healthy baby and a healthy Chelsea. And I'm okay with the midwives and doctors doing what they need to do for this to happen. I'm a bit sad about the prospect of losing some options - induction comes with fetal monitoring and pitocin, which makes contractions longer and stronger and more difficult to handle without pain medication - and it's an IV which means it also comes with fluids. And if they don't have a telemetry unit then I will need to be tethered to the monitor and I won't have as many options for different positions during labor to ease the pain... one thing leads to another. I'm sad to think about not birthing at the birth center, and having to deal with all the hospital mumbo jumbo at UNC, which I'm not familiar with because I haven't planned to birth there. I'm excited to see Baby B a few more times before (s)he is born (via ultrasound), but nervous that all those scans will allow for the possibility of a slip-up and we'll find out the baby's sex.
But we'll see what happens. And in the meantime we'll prepare ourselves as best as we can. We already have a plan to schedule my prenatal massage for the day I turn 38 weeks because the lady who does the massages has special things she can do to help induce labor once you're at 38 weeks, and right now it looks like my safest bet is to go into labor early if I want a spontaneous labor and as many birth options as possible. Time will tell.
Grateful for labor.
It changes a person's take on labor when you're grateful for the opportunity to try it - for the chance to see what you can do.
I think I needed that message last night. Because this morning I had my 30-week appointment and I left feeling not so great. My pregnancy has really been good. I have vomited all across the Eastern half of the country, but still my nausea hasn't been as bad as some experience. And nausea is something I can manage alright. My health and Baby B's health haven't been in danger. I've gained 6 pounds total, so I'm not gaining too much which was one of my fears going in to the whole thing. I've measured exactly where I need to be at every appointment (fundal height measurement). Baby B's heartrate has been in the normal range. I don't have gestational diabetes... things have just gone really well. But then today, they tell me that because I have a history of chronic hypertension, I will not be permitted to go past 40 weeks gestation. I will need an ultrasound every month from now to 36 weeks, and then one weekly from 36 weeks to delivery. I will need two non-stress tests each week starting at 36 weeks. The concern is that my history of chronic hypertension could be prohibiting enough blood and oxygen from reaching the baby, causing premature aging and inadequate growth.
To which I say... WAIT A MINUTE HERE. I asked about induction weeks ago and you said that your policy is not to induce before 42 weeks, provided things look good. No mention of this sudden 40 week induction deadline.
Actually, I just sat there. I only asked two questions. One - does this induction thing apply even if my blood pressure is fine at 40 weeks (as it has been throughout my entire pregnancy - below 120/80 at every single appointment)? The answer was yes. And two - you're saying I'll have three appointments per week, one of them at UNC (awful awful parking situation), every week from 36 weeks to delivery? The answer was yes.
So I let the midwife check the baby's growth (30 centimeters and I'm at 30 weeks) and heartrate (150s) and position (vertical) and movement (she could see Baby B dancing around while she was taking the heartrate). And I left and called Jonathan to fill him in. He was planning to come today but we agreed that he wouldn't because he has to miss some work tomorrow afternoon for our meeting with the mortgage lender. And Jonathan had a bunch of questions, like why didn't they inform us of this policy, say, IN JUNE WHEN THEY KNEW I HAD HYPERTENSION FOR HEAVEN'S SAKE THEY'RE THE ONES WHO HAVE HELPED ME MANAGE IT AND I EXPLICITLY ASKED THEM IF IT WAS OKAY FOR ME TO BE A PATIENT THERE AND HOW THAT WOULD WORK AND... Jonathan was a bit upset. I was still processing everything but he had jumped ahead to frustration. I soon joined him there. He promised to come to my sonogram next week and appointment at the Birth Center the following week, where we'll be prepared with lots and lots of questions and at least one clear brain for asking them between the two of us.
In the end, we want a healthy baby and a healthy Chelsea. And I'm okay with the midwives and doctors doing what they need to do for this to happen. I'm a bit sad about the prospect of losing some options - induction comes with fetal monitoring and pitocin, which makes contractions longer and stronger and more difficult to handle without pain medication - and it's an IV which means it also comes with fluids. And if they don't have a telemetry unit then I will need to be tethered to the monitor and I won't have as many options for different positions during labor to ease the pain... one thing leads to another. I'm sad to think about not birthing at the birth center, and having to deal with all the hospital mumbo jumbo at UNC, which I'm not familiar with because I haven't planned to birth there. I'm excited to see Baby B a few more times before (s)he is born (via ultrasound), but nervous that all those scans will allow for the possibility of a slip-up and we'll find out the baby's sex.
But we'll see what happens. And in the meantime we'll prepare ourselves as best as we can. We already have a plan to schedule my prenatal massage for the day I turn 38 weeks because the lady who does the massages has special things she can do to help induce labor once you're at 38 weeks, and right now it looks like my safest bet is to go into labor early if I want a spontaneous labor and as many birth options as possible. Time will tell.
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