Wednesday, November 24, 2010


I went to the midwife on Monday, and everything's fine with the baby and me (heart rate: 144, measuring 34 centimeters at 34 weeks, my blood pressure was great, I gained another pound - total 17)... but I was so upset by something that I haven't been able to write about it until now.  Actually, I spent most of Monday night and Tuesday morning in tears.

The OB who delivered the girls isn't practicing in our town right now.  He left the group of physicians he was with, and had a covenant not to compete, so he can't practice here until April of next year.  I considered driving about an hour to Illinois, where he is practicing, to continue to see him - he still takes my insurance - but I decided that it would be too inconvenient, especially with my fast labors.

So when we saw the midwife for the first time, I said, "Here's the deal - with my first I had preeclampsia, was on bedrest for a week, and delivered naturally at 39 weeks in 3 hours and 45 minutes.  With my second I had preeclampsia again, I also had ICP, and I was induced at 36 weeks.  My labor was only an hour and 9 minutes.  In light of all that, and since ICP has a 60-90% chance of coming back, I want to be induced at 37 weeks.  If you can't do that, or deal with all these complications as a midwife, I'll find someone who can."  I wasn't hostile about it, I was just putting my preferences and expectations out there right up front.

She said, "Well, we don't know that the preeclampsia will come back - after all you've lost 50 pounds since then.  And there's a 10-40% chance that the ICP won't come back.  We normally induce for precipitous labor at 38 weeks."

"I can live with that," I said.

On Monday I said something about 38 weeks, and she said, "39 weeks."  Apparently (according to BJ's cousin's wife who is an L&D nurse) the rules changed about two months ago.  Of course I didn't know that at the time.  I was too stunned to even question her much.  I've gotten VERY comfortable with 38 weeks over the past 7 months, and I felt like she had pulled the rug right out from under me.  Part of my disappointment was that I felt like she'd lied to me.  That part went away when I found out that the guidelines had changed.  (In fact, some insurance companies are refusing to pay for some inductions which they deem "too early," which just makes me want to spit nails). 

Part of it was that 38 weeks is 12/22 - 39 is 12/29.  It's the difference between being enormously pregnant and uncomfortable on Christmas and having a new baby at home on Christmas.  It's the difference between having BJ home for 12 days after the baby's born, and having BJ home for 5 days after the baby's born.  It's the difference between having my mom here for a while after the baby's born, and Mom going back to Florida.  I'd gotten really, really invested in the idea of having the baby by Christmas.  More than I realized, actually. 

One of these days I'm going to learn that when I have expectations, I inevitably end up disappointed.  I sometimes wish that I couldn't think in the future tense at all.  I get these ideas in my head about how things are going to be, and then the reality is never what I had imagined, and even if the reality is better than what I imagined, I get all upset over the loss of the imagined reality.

But the main component of my 'tude about the change in plans is that I'm deeply, deeply afraid of having this baby at home.  Remember all that anxiety I've been battling?  It all came right back in spades.  I cried a lot on Monday night.  Mary Grace heard us talking and said, "Mommy, if I can come along (to the hospital) I can protect you and keep you from being afraid," and I felt horrible enough for worrying her that I was able to suck it up for a while.  I had nightmares on Monday night, and lost a lot of sleep.  Then Tuesday I cried some more.  I didn't sleep well last night, either.  The last two days have sucked.

Even though I wanted a homebirth with MG (BJ said, "No freaking way," though), the idea of a homebirth terrifies me now.  (I also was adamantly against being induced with MG, and now I want to be induced.  I'm like the Ziggy of childbirth).  For one thing, we have new carpet and a new mattress.  For another, what would we do with the kids?  Or the dog??  For a third, who is going to clean it up?  What if there's a blizzard and the EMTs can't get to our house?

The midwife's answer to all of this was to get a shower curtain (to protect the bed), and to visualize having the baby in a calm, controlled, normal length of time.  I'm trying, but I really don't think I can visualize my way out of this.  And a shower curtain isn't going to do diddly squat if the baby doesn't breathe (pneumothorax is a complication of precipitous labor - it means collapsed lung), or if I bleed to death, or if I have a cervical tear, or if something else tears, or if the baby is brain damaged, or any of the other bad things that can happen with precipitous labor that I'm not making up.

I feel marginally better today (mainly due to finding out that the midwife didn't lie when she said 38 weeks initially), but I might just be exhausted.  I'm trying to convince myself that Claire's labor was so fast because they induced me with Cytotec, and that I shouldn't expect this labor to be that fast again if I go into labor naturally.  I'm also trying to convince myself that the 4 hours between when they put in the Cytotec and when they broke my water "count" as labor, even though they didn't hurt and I've never thought of them as labor - I was mainly just hanging out in the hospital wondering if that twinge might have been a contraction.  I can totally get to the hospital in 5 hours and 9 minutes, or 3 hours and 45 minutes.  It's the less-than-an-hour scenario that scares me.  I'm hoping that my friend Tammy, who dreams about babies with surprising accuracy, is right when she predicts that I'll go into labor on my own on 12/15 and have a boy (12/15 is 37 weeks - the leading edge of "term").  I'm trying to remember that I have a chance of going into labor before Christmas on my own, and if not, I'm trying to get excited about a different reality for Christmas this year - mainly not having to miss all the parties leading up to Christmas.  After all, if she's not concerned enough to induce me, and if going to labor before 39 weeks on my own is so rare, then there's no reason for me to sit at home all month not having a baby.  We'll just take our shower curtain with us.

I know this is a stupid reason to be upset.  The baby is healthy.  I've been healthier than anyone expected me to be throughout the pregnancy.  I'm trying really, really hard to count my blessings.  And I'm trying to let go of all my expectations. 


Cate said...

Hey Amy -- it's a sure sign that the end is near when the weepiness shows up! You could always try some primrose oil or other natural inductions around the time of the 15th.... I mean, if none of those are contraindicated with something else you've got going on. Stairs! Lots of them! :) Thinking of you a bunch.

Heidi said...

Breathe Amy!

And again...

Okay, better? Yeah, well, it was worth a try... I agree with Cate; my midwife suggested PO when I went past due with my first. Check with yours, just in case.

Babies - AS YOU KNOW - never come when or how we plan. I mean, when you got pregnant with MG, did you plan for complications? No, you didn't. All we've read/are told/experienced with our last kids are GUIDELINES. Nothing is written in stone and you know it. You. Know. It. Have confidence in the knowledge that no matter what happens you CAN handle it and choose to let go of the anxiety. You can. I know you can. Make the conscious effort. Yes, it sounds stupid, but I've been there and if I can do it, you can do it.

On way or another you will have a beautiful baby to ring in the new year with. Just think of toasting at midnight all you've accomplished. Because we know... you'll be up anyhow!! ;)

Stefanie said...

Oooh, I know that worry, the not making it to the hospital dread. I had precipitous labor the first time. I appreciate your post, believe me, your not alone. Some of my thought exactly.

Mrs4444 said...

I'm sorry you're feeling stressed. I can relate to having expectations, especially about something so big. Good luck with your decisions; it will all work out.