I had my appointment yesterday to see my primary OB about a birth plan. I figured she would give me until my due date to go into labor on my own as long as baby was looking good until then. Then I figured she would have me scheduled for an induction on or close to my due date that could be changed to a c-section if needed. So, I’m sure you can imagine that I was a bit surprised when she told me we were scheduling an induction for next week at 39 weeks. I’m not giving the exact date on here for privacy reasons but those who know me IRL are free to ask me and I will give you all the details. I asked the Dr if she was sure about scheduling now and she said yes, because the few days more that she would be willing to let me go probably wouldn’t make a difference as far as me going into labor on my own. At this rate, even an induction is a long shot for several reasons:

  1. My cervix has made no changes in 2 weeks since they started checking me. It is posterior (I was wrong last week about it being anterior. It’s posterior and that is not a good sign for successful induction.), not dilated, and soft but not completely effaced (didn’t think to ask exactly how effaced though).
  2. Baby had the incident earlier this week on the NST where he had a sustained drop in heart rate with my contraction. That is not a good sign. If he has dips in HR from my piddly Braxton Hicks, then pitocin contractions could very well cause enough dips that we cannot proceed with induction and just have to go in for c-section.

But I am thankful that, barring any other problems that might pop up, at least for now I am getting the option to try to VBAC. I really don’t have any high hopes for it to be successful. My Dr seemed to think that 70-75% chance of success was possible especially if baby tolerates the contractions well. The Dr scared the pants off of me for a few minutes when she brought up that she thought one of my earlier ultrasounds showed signs that the placenta had grown over the scar and that there was a chance that talking about a VBAC was pointless since I may be having a hysterectomy. Thankfully she didn’t leave me in agonizing suspense too long as she took me over to the ultrasound room and did a quick ultrasound herself and decided that the placenta is most likely in a good spot afterall. Thank God! The H word sure scares me! I’m only 25 and I really like my parts all to stay intact a good while longer!

 

I am still considering changing the date for the induction against my Dr’s preferences to the following week around my due date. But I also realize that if I do that, the chances of him not tolerating labor and contractions will be at least the same as now if not worse and also, every week that I go is potentially growing him a half pound larger. Since we think he will be about 8 pounds by next week if not more, I don’t really think that waiting till he is even bigger is going to be doing either of us any favors.

 

We talked about a more natural cesarean approach if it ends up coming to that. The Dr made it clear that it is not in her usual practice to do family centered c-sections but that she would definitely be willing to work some things around to make it happen as long as we are not having an emergency situation. I requested:

  • Immediate skin to skin. I don’t think she is willing to do this immediately but she made it sound like we would try to do it sooner than waiting for me to be moved to recovery like last time.
  • Not having my arms strapped down. Again she didn’t say yes, but she also didn’t say no. I think we can make this work.
  • I told her I don’t want any narcotics like I had last time. I hate the way they make me feel. I don’t want that at all during the birth. She said I need to make that point to the anesthesiologists. This one is perhaps the most important.

I also talked to her about the epidural line. I am afraid to have it because I am scared of the potential for a spinal hemorrhage resulting in permanent paralysis. She said that the choice is mine but in the rather likely event of a c-section, I would be going under general anesthesia. I think I will go with the epidural line getting placed because I am very afraid to miss out on my baby’s birth. But she said I can have it turned on at any time I choose during the labor, I don’t have to get it turned on immediately. I am supposed to stop my Heparin the day before the induction and I am supposed to stop the aspirin now so that should lower the risk of problems with the epidural. I am giving myself grace about the epidural. I have heard so many horror stories about the pain of Pitocin contractions so I plan to try without the epidural on but I will give myself grace, whereas if I was laboring naturally, I would try much harder to get through it on my own if for no other reason than being able to move around and try different laboring/birthing positions. That is SO IMPORTANT to me.

 

The plan is to start induction with pitocin. If I am at all dilated by the time I get to the hospital, the Dr said they will try to insert a Foley Bulb to dilate the cervix. If I’m not dilated at all, they plan to start the pitocin and try again with the Foley after the pitocin has a chance to work. I really hope we can use the Foley because I know the dose of pitocin will be extremely low because of the previous c-section scar and I need all the help I can get to move that cervix along. I also want to use as little pitocin as possible because I am a little worried about the extra risk of uterine rupture which is small but still scares me a little. The Dr said with a natural labor the risk would be only 0.7%.

 

She said I can move around during labor. Not walking but sitting on the ball and using different positions. I am wondering if I can change her mind about the not walking part although that means I have to push around an IV pole. I forgot to ask if they can do remote monitoring of the baby. I do want him monitored the whole time as I am sure they will also want to do.

 

So, yep. I think that is about the gist of it. Unless labor starts earlier or I don’t chicken out about the induction dates, that is the plan. I do hope to try acupuncture twice next week. I am not trying any other natural labor inducing methods right now though. I may yet try pumping, maybe on the day of my next NST and possibly before we go to the hospital to induce. I don’t know.

 

I am feeling bummed out that I probably will never experience that whole “Honey, I think it’s time!” or “These contractions sure do seem mighty consistent! I think we better time these.” labor. But still, the fact that I might get to actually experience even a bit of labor makes me happy. If we do end up with a section, hopefully it will be a much better experience than last time. Pray for us! πŸ™‚

 

Dear God, may Your will be done regarding Levi’s birth. I pray that You will bring him safely into our arms and in the perfect way You have planned. Please make the labor and birth go beautifully and be a happy and healthy experience for all of us. In Jesus’ name, amen

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