Tag Archives: induction

Cleared for Launch (36w6d)

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Today was my last prenatal appointment. Short and sweet.

  • BP: 154/97 both times
  • Fluid: 5.7 in only two pockets (dunno if that’s good that they were big, or bad that there were only two.)
  • Monitoring: Little man seemed content to kick at the monitors, so he didn’t need to be buzzed.
  • Group B Strep test was positive, so I’ll need 2-3 doses of antibiotics during the course of labor. No big deal, just one more thing going into the IV.

    • We chatted for a bit with our favorite nurse, Paula. She’s a neat lady. Hugs all around when we left.

    So we’re cleared to arrive at the hospital at 7:30 on Sunday. This is getting very real all of the sudden.

Still here (36w4d)

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Quick & Dirty update:

  • BP was 155/99, so in the unhappy-ish range and up from Monday.
  • Monitoring went well (no buzzer needed)
  • Fluid is back up a bit to 5.7 (although Dr. Schwartz told us on Monday that he has a sneaking suspicion my fluid has always been a little higher than AFI readings are saying – just because on someone of my shape and size there’s more ‘nooks and crannies’ for fluid to hide in. Doesn’t make visualizing them or getting to them for an amnio any easier – but it does explain why he hasn’t been all Chicken Little like the nurses for the last two weeks.)
  • Gave blood and pee to re-check stuff and was sent home (as opposed to the hospital.)

If I wasn’t scheduled for induction on Sunday, they’d be having me do a 24-hour urine starting tomorrow. So thank God for small favors.

Worrisome upper belly pains + increasing headache + vision changes are making Dr. Schwartz look at me funny, but he let me go home today, so I consider that a victory. It’s possible the lab results will change that tomorrow, but we’re thinking positive. In the meantime, I’m trying to lay low – which is fairly easy today cuz I kinda feel like crap between an upset tummy, headache and the upper belly pains.

I guess I should clarify that the induction on Sunday isn’t something we’re expecting to go especially quickly. At not quite 37 weeks, I’m high and tight (not dilated or effaced at all) so I’m assuming it’s gonna take at least the full 12-hour cycle of the Cervidil to get things moving, if not a second round. (Our prepared childbirth instructors warned that it’s not at all uncommon for two rounds of Cervidil to be needed for induction before 38 weeks.) I’m not contracting anymore though, thank goodness. If the contractions from the amniocentesis had continued more than 8 hours or so, that would have been a problem. So while a shared birthday with Daddy is possible for June 30th, I’m not aiming for it. Personally, I think the little guy is gonna arrive on the 29th – but the 28th would be even better! As always – safe and healthy baby and Mama is all we’re after, however that comes about.

I’m back at Dr. Schwartz’s office on Friday for monitoring and possibly an amniocentesis if there’s a big fluid pocket that the doc of the day (not Dr. Schwartz) feels like trying to stab at. (Uug, that sounds gross, doesn’t it?) I’ll say goodbye to the girls in the office who we’ve gotten friendly with (I swear, it’s like Cheers when we come in now: a chorus of “Hi, Sarah” wafts out of the back.) If I end up with a Cesarean, I’ll be in the office for a follow-up at two weeks. If I manage to do a vaginal birth, I won’t see anyone in Dr. Schwartz’s office (including Dr. Schwartz) for six weeks. (He’ll still manage my insulin and meds during that time, but we’ll do that via email only.)

So, in the meantime I plug away at work stuff and Paul tries to keep me from working too hard. :)

Amniocentesis FAIL (36w2d)

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So my fluid was at an all-time low of 4.5 today, and even with Dr. Schwartz’s Jedi-like skills, the amniocentesis couldn’t be completed today. There was one tiny (1.2cm) pocket he was aiming for, but the kid kept putting his arm there when Dr. Schwartz got close with the needle. Paul watched on the monitor as they tried and tried to get into the pocket they were aiming at.

I got jabbed twice though. Not as bad as I thought it would be at all. The pressure was the worst part – until the contractions started. (It’s two hours later and they’re still happening…) It wasn’t pleasant by any means, but I’m not shaking in my boots at the prospect of another one.

So the plan is to wait another week. Since we can’t absolutely confirm that the little guy’s lungs are mature enough to be on the outside, we hang out. I’m still doing OK enough (surprisingly) that we have time before things get to a crisis point. So we’ll continue monitoring me this week, and on Friday I’ll be checked by one of the other doctors in the office. If he sees a big pocket of fluid, they’ll probably go ahead and attempt an amnio – but if not, it’s not a problem. I’m scheduled to arrive at the hospital at 7:30 on Sunday evening to start the induction. Dr. Schwartz will come straight from the airport on Monday morning to check on me, and we’ll take it from there. (Friday’s potential amnio would only be to tell us something wasn’t right – not to give us the go-ahead to induce. The default now has been flipped to induce, as opposed to waiting for confirmation.)

We were pretty disappointed. Paul and I had worked this weekend to get ourselves to a good head space for having the kid today. We felt ready. (well, as ready as one can feel…) So it was a pretty big let down today, and Dr. Schwartz recognized that. But we agree with him that discretion is the better part of valor and to err on the side of caution is a much better way to go right now. Paul is concerned for me having to stick it out another week, but I’m fine. Letting the little man have an extra week is all to the good for him, and I can put up with basically anything for another 6 days.

I’ll be going in to start the induction process at 7:30 on Sunday June 27. It’s entirely possible that the whole process will take 2-3 days. Paul’s birthday is Wednesday the 30th. Could be fun if his son shares his birthday. (Considering Paul was born on his parent’s 3rd anniversary.)

For now though, we’re finally back home. The appointment today was over three hours long with 30 minutes of monitoring before and after the amnio. We know what a contraction looks like on the monitor now! I’m dead on my feet and in a fair amount of pain in my upper-mid back and from the continuing contractions, so I’m gonna lay down for a nap. I’ll be working the rest of this week, so I will be staying busy between monitoring appointments on Wednesday and Friday afternoons.

Sorry for the big build up to nothing, folks.

Holding Pattern & Why I LOVE Dr. Schwartz (35w4d)

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Fairly boring appointment today. Did the test for Group B Strep, the results of which should be back on Friday. (Most people carry Group B Strep on them with no worries, but if I’m currently carrying it, the baby can get REAL sick if exposed to it during a vaginal birth. Two doses of antibiotics via IV during labor will take care of it if I am positive.)

Amniotic fluid was back up to a 6 today, so that’s good. Little man was happy to show us how well he practices breathing, and had fun kicking the ultrasound transducer. Monitoring was the same as usual, requiring the buzzer to get things going. But once he woke up, he proceeded to kick the contraction monitor pad for about 5 minutes. His heartrate did a scary little deceleration thing a couple of times, but he bounced back quickly – so that’s OK.

Blood pressure was mixed: 164/97. So it was higher than it has been, but the diastolic was under 100, which is good. Dr. Schwartz said he was OK with my BP today, so yay.

Paul and I chatted with Dr. Schwartz about the plans for the rest of this week and next. (We also talked about developing an iPhone app vs a fee-for-service website…) But once we got home, Paul was explaining to his Dad what my status is and kinda had it all wrong. We talked, but Paul was still pretty convinced that he had it right and that the induction wasn’t happening unless it was an absolute emergency. So I e-mailed Dr. Schwartz. Below is the actual e-mail conversation (along with an explanation of what’s up for the next 5 days):

On Jun 16, 2010, at 8:10 PM, Sarah wrote:

Sorry to bug you, but Paul and I seem to have heard completely different things at today’s appointment and I’m hoping you can clear things up.

I’m under the impression that barring any significant change to my condition, you’ll do a Jedi-worthy amniocentesis on Monday morning which will confirm binary-style whether the little man’s lungs have matured enough to be on the outside. If the test comes back with a yes, you’ll have me report to the hospital Monday evening to start the induction. If the amnio comes back saying baby’s lungs aren’t mature yet, we’ll hang out and do another amnio a week later to check lung maturity then.

Paul is under the impression that I’m not being induced until the situation becomes an emergency, and that Monday’s scheduled amnio is just to give us an idea if the baby could handle being outside the womb when that crisis time comes, whenever that is.

So, who’s got it right?

Sarah
——-
Hi,

As is probably the case in any disagreements that you and Paul might have, YOU heard correctly and Paul is wrong. Please feel free to refer Paul to this email throughout the rest of your life.

JKS

Sent from my iPhone

I LOVE my OB so freaking much. So we’re just hanging out for monitoring on Friday and then the amniocentesis on Monday morning. We’ll have results that afternoon, and either we’ll be at the hospital that evening, or we won’t.

Possible change in plans… (35w2d)

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Today’s appointment for monitoring was pretty darned good. I walked in feeling better than I have in a while. Excellent blood pressure again (147/90) and after some not-so-gentle prodding, good numbers from the kid on the monitoring strip. (He did not appreciate me chugging half a bottle of ice water to get him to move and getting my whole belly woggled by the nurse.) Trace amounts of protein in the urine (up from zero) but not OMG either.

The bad part comes during the ultrasound where they’re measuring the amniotic fluid around the boy. The levels should be around 14 on average, with 5-25 being the extreme low and high ends of the scale. Anything at or below 5 is cause for major concern. I’ve been sliding down that scale and was at a 6 on Wednesday and Friday last week. I forced fluids this weekend, making sure I was taking in well over 100 ounces a day in the hopes of bumping up that number.

Today all the head nurse could get was 4.8 – and that was after 20 minutes of looking and looking all over. So the oligohydramnios is very much in affect. What exactly this means, we’re not sure. We know it ain’t good, but the fact that this is happening towards the end of the pregnancy as opposed to towards the beginning is good. If it were at the beginning, it would be because of some abnormality with the baby. Now it’s just a culmination of my pre-existing medical conditions: hypothyroidism, hypertension & diabetes.

Dr. Schwartz is in his other office across town today and tomorrow, so they called him while we were at the office to see what he wanted to do. We were sure he was gonna send me over to the hospital. But he asked to see me in his other office tomorrow instead. So we’re taking that as a sign that there’s no need to totally freak out just yet. Mostly what oligohydramnios means at this point is that delivery is gonna be a bit more complicated and the chances of a cesarean are probably higher. There isn’t anything they can really do to reverse it – like putting me on a saline IV to pump me full of fluids or something. (There are some therapies that involve pumping fluid directly into the placenta, but those are mostly for use *during* labor.) There isn’t enough amniotic fluid around the baby to *do* an amniocentesis – so we don’t know how much that will blow out next week’s plans. With such decreased levels of fluid/cushioning around the baby right now, the chances of him laying on his umbilical cord and squashing his blood/oxygen/nutrient flow increase. This is where I am SO GLAD that I completely trust Dr. Schwartz and his knowledge/experience in treating high risk women like me. Whatever he says tomorrow is OK with us. If he still wants me to try for a regular birth, I’m all for it – but if this situation necessitates a cesarean from the get-go, we’re OK with that too. Whatever gets our little man out safely.

So this afternoon and this evening are final prep, just in case. All bags are being packed (we were doing laundry this morning already) and final arrangements are being made. I’m gonna try to go get my nails done. Gonna get the Ragu Bolognese made and in the freezer, along with the Creamy Italian Chicken. (There’s a lot of simmering involved there – I’m not gonna be slaving over a stove.) We’re hoping that Murphy’s Law will kick in if we get all this stuff done tonight. Paul is pretty anxious, but I’m doing pretty OK. I am keenly aware that I need to stay calm, and having tasks to focus on helps me greatly with that.

We’ll update tomorrow after the appointment here and on Facebook. (Facebook will probably get updated faster because it’s easier to do from our phones.) We’re halfway expecting to be told to go to the hospital from our 9:00am appointment. I’m all the more glad that we have a 7:45am appointment to meet the pediatrician tomorrow. Gonna be a busy day. Prayers would be appreciated.