Monday, June 16, 2014

Eden's Birth Story, Part II: Scheduling a Hospital Induction

[Missed Part I? Click here!]

I woke up Tuesday morning refreshed from deep sleep. The emotional end to the previous day felt like a distant dream now that the sun was up. Yet, I was still a little nervous about the non-stress test ahead of me. I followed my midwife's advice to eat or drink something with a good amount of caffeine or sugar, as monitoring the baby while he or she moved was the main purpose of the test. I enjoyed a large iced coffee in the car on the way to the clinic for our 10:00 appointment.

41 weeks and 6 days pregnant, the day of our non-stress test
We didn’t have to wait long to be seen. The nurse led us back to a small examination room where she hooked me up to a fetal monitor. We immediately saw several bouncing lines start scrolling across a computer screen. Pointing, the nurse explained that a particular line recorded the baby’s heartbeat. She handed me a small wand with a button on the end. When I felt the baby move, I was supposed to punch the button. The frequency of the baby’s heartbeat was supposed to increase immediately following movement.
And then the nurse left, saying she’d check up on us in about five minutes. Jon kept Jadon occupied with snacks and an app on his phone. I waited for the baby to move, but felt nothing. Five minutes passed.

The nurse returned, took one look at the screen, and said, “Baby must be sleeping, huh?”

“Yeah, looks like it,” I replied.

Then the nurse offered to get me a glass of apple juice, as that usually gives a sugary burst of energy to the baby. I accepted the offer.

When she returned with the cup of juice, I asked how long this test usually takes. “Well, it takes as long as it takes for your baby to move,” she answered.

I downed the juice. “And what if the baby doesn’t happen to move?”

“Then we may have to send you over to the hospital for some closer monitoring.”

Great. Exactly what I was afraid of. More tests. I knew that my baby was fine, and that he or she had been moving plenty that morning already. However, if the baby wasn’t moving during this test, I was out of luck. I literally couldn’t make this baby move, and I couldn’t leave until he or she did.

Thankfully, just minutes after drinking the juice, I felt a nice hard kick. I immediately pressed the button, joyfully telling Jon that the baby moved. I saw relief fall over his face. The heartbeat line on the screen steadily climbed, and then gently fell back to the normal frequency. Then the baby moved again. And again. And again! The heartbeat peaked after each movement, and always returned to that healthy, steady rhythm.

When the nurse reentered, she looked at the screen, smiled, and remarked that the juice seemed to be working. Since there was plenty of data to see, she left again, this time to get Dr. W.

“Wow, your baby’s a rock star!” remarked Dr. W as he glanced at the screen. “But, I thought I wasn’t supposed to be seeing you folks again! I guess your baby’s pretty comfortable in there, huh, Alison?”

I laughed, glad that he seemed to be laid back about going later than we expected. He explained to us that the non-stress test looked excellent, but he also wanted to get a quick look at the baby on the ultrasound screen to make sure the fluid levels were appropriate, and that the placenta looked healthy. Even though we prefer having only one ultrasound performed at twenty weeks, we agreed that a quick ultrasound was wise and would give us peace of mind as we continued to wait.

Our entire crew shuffled to another examination room with the ultrasound equipment. It took less than five minutes for Dr. W to see what he was looking for.

“Okay, let’s see…well, baby is head down…now I'm looking for a fluid pocket…fluid pocket…here’s one…but the cord is present in the shot, so I’m not allowed to do a reading on that one…another fluid pocket…it's a nice size, excellent size…okay, now for the placenta…it’s still nice and high, away from the cervix and your scar tissue…wow, it’s really in excellent shape, only slight traces of calcification near the edges, which is wonderful at the 42 week mark…well, that’s all I need to see…everything looks great!”

As I cleaned the goop off my belly, Dr. W reasoned with us about the days ahead. He explained that there was no reason to induce simply because I had reached the 42-week mark, especially when the baby and I were both in such good health. However, he continued to say that the probability of unexplained stillbirth rises exponentially between 42 and 43 weeks, and that he really wasn’t comfortable letting the pregnancy continue past the weekend. He proposed that we come in for an induction on Thursday, only two days away, and one day past 42 weeks.

At this, my husband piped up. “Doesn’t it make more sense to come in for another non-stress test on Thursday, and then consider an induction on Friday, especially if the non-stress test isn’t as favorable as the one we had today?”

Dr. W paused, but agreed to scheduling an induction for Friday. I had a lot of questions about what would be allowed if I was to labor in the hospital. I found out that I would be allowed to walk the halls and move around the room during my contractions, and that I would not have to push laying down on a bed. However, I would have to have a wireless fetal monitor on me at all times, and an IV saline lock in my arm in case they needed to administer fluids or medications. He saw in my face that I didn’t like the idea of continuous monitoring, or the IV. Then he said, “I know how much you want to have a home birth, Alison, but how important would you say it is for you to have a vaginal birth?”

“Having a VBAC this time around is probably my top priority, even if it has to be done in a hospital.”

“I am committed to giving you a VBAC, Alison,” Dr. W said earnestly. “This means that I won’t be giving you any kind of timeline if you are laboring in the hospital. If you arrive on Friday morning, I know that you may be here all day Friday, and Saturday, and maybe even Sunday. As long as you and the baby continue to look healthy, I want you to have as much time as you need to have the VBAC.”

So, we scheduled the hospital induction for Friday morning at 7:30 am. My heart was heavy, but I was grateful at the same time. I knew that not every doctor would be as gracious as Dr. W in allowing the pregnancy to continue at all! Furthermore, doctors are notorious for putting time constraints on labor, especially if a woman’s water has already broken. Yet, as generous as his “no time limits” offer was, I knew that chemically inducing my labor complicated my hopes for a VBAC. Pitocin-generated contractions are a lot harder on the uterus, and scar tissue, than contractions stimulated by the body’s own natural oxytocin. Continuous monitoring could show “distress” or other issues that were actually caused by the induction itself. 

The more I thought about a hospital birth, the more resolved I became to have this baby before Friday morning.

On the drive home, I texted Pam (my midwife) and Alison (my doula) to share the good results of the non-stress test, and the ultrasound. I also told them that we had scheduled an induction, but that I would be taking some more castor oil when I got home. This baby needed to come out.

Stay tuned for the final Part III, coming soon!

1 comment:

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