Well, Wednesday was the due date. I had an appointment that morning where they did a sono and a non-stress test (hook the monitors up and see if everything is okay for 20 minutes).
By sono, she's currently 9 pounds 4 oz. I have plenty of amnionic fluid, in fact, at one point, they thought too much. So, even at 9#4oz, she's still floating and not engaged. My cervix is tight and not effaced.
I've had in my birth plan since 20 weeks or so that I want to go as natural as possible. I'm wasn't against an epidural necessarily, but I wanted to see if I could go without one if possible.
So... at this point, she's getting so big - even though today is just my due date. They're asking me to think about induction, but don't seem concerned yet (but I'm thinking they're just honoring my birth plan wishes to a certain extent). They're having me come back for another non-stress test on Monday.
I'm worried that if I let her go that I'm going to need an c-section. I'm also worried that if I induce that I'm going to need all the medical interventions (the stuff to ripen my cervix, the pitocin, and epidural because the contractions will be so strong, breaking my waters, and then if all that doesn't do anything, or because she's so big, I'll end up with a c-section anyway). So, I'm really torn and don't know what to do.
I mean, if I just let her go, who knows when she may actually engage and cause my cervix to do anything... and by the time she does, she may be too big to deliver vaginally anyway. Yet, I'm really scared of inducing.
I wrote an e-mail to Trupin asking question. Tiffany (the nurse practitioner) wrote back that she would prefer to talk to me in person. I could make an appointment for today or just keep my Monday appointment. I decided to keep my Monday appointment.
I've been getting a lot of great advice from the three places I posted and asked questions. The three are the PPBB, a "natural parenting" board and the pregnant-atkids yahoo group.
One thing that got me to thinking was that one of the major complications of going forward with a vaginal delivery of a "big" baby is stuck shoulders - or shoulder dystocia. Anyway, I started reading a website about it and it confirmed what the midwife online told me about sonos being inaccurate after 4000 grams (or 8# 13oz). So... being the dork that I am, I did some calculations. At 37 weeks, the sono said 7# 2 oz - so that should be relatively accurate since it's under 4000 grams. The shoulder dystocia website said that a good estimate of fetal growth is to add 30 grams per day. So, if I do that, at 40 weeks, I get 8# 8oz rather than the 9-4. By next Wednesday, she'd be at 9-0 and by Xmas day, 9-7. That at least makes me feel better.
However, the one scary thing is that being obese, overdue, and having a large baby (over 4000 grams) are key risks for shoulder dystocia. The others is a long second stage of labor (which I won't know until I get there) and gestational diabetes (which I don't have). Anyway, then the site lists recommendations based on risk factors. A C-section is recommended for non-diabetic mothers with babes whose EFW is over 4500 grams (which equals 158.8 ounces, or 9 pounds and almost 15 ounces). Heather's not there yet, but if you do the 30 grams per day based on the 9-4, then she'll be there on the 21st. That's not even two weeks past due, and supposedly, my OB will let me go two weeks over if I want.
Then, if I want to get really freaky with the numbers... Going from 7-2 to 9-4 (assuming that's accurate, which is probably isn't) in three weeks means that Heather actually was gaining 45.9 grams per day on average during those three weeks. So, if I assume that same growth rate, then she'll be over 4500 grams not in 10 days, but in only slightly over 6 days. So, that's by next Wednesday! A C-section, recommended by next Wed. We're not talking just recommending induction, we're talking that some doctors would recommend a C-section at just one week past due date.
But.... I'm not really freaking as much as it sounds like I am. It's just interesting to look at the numbers. It will be interesting to see what my OB has to say on Monday.
In the meantime, I feel great - better than I have been lately. Heather's moving a lot. But, I don't feel any changes down below either. A lot of what people recommend doesn't do anything to bring on labor unless your cervix is ripening. So, I'm looking at things that cause the cervix to ripen (like sex, evening primrose oil, etc.). This is going to help either way, because inducing without a ripe cervix doesn't get you very far.
I need to remember and feel blessed that I'm able to grow such a happy baby in there that she just doesn't want to come out.
Labels: Old
