What an appointment....(pregnancy vent)

[Amiens]

So I had my 29 week appointment today, and I should have taken a hint from my dream last night......I had a dream where I asked my doctor to induce me and I was 38 weeks and 4 cm dilated, and she said "No! It's way too soon." I woke up in tears.

Anyway, I went to my appointment where apparently it was my doctor's first week back from maternity leave. I showed up 10 minutes early and still it was 30 minutes until I saw her. I am up 4 lbs from my last visit for a grand total of 29 lbs, at this point I had such a crappy appointment that I don't care about my weight gain-- all I want to do is eat the bag of Halloween candy sitting next me. As I said earlier I should have taken a hint from my dream- I told my OB- "So you mentioned you would induce me a week early. We found out that Matt has a week of vacation the previous week." Well she then throws out all of these statistics about NICU babies and how she won't induce me before the 12th of Dec. That's fine, I understand the risks involved. But then she goes on about how if I don't want to have the baby so close to Christmas she will induce me between the 14th and 19th, and how if Matt were being sent to Iraq then she would induce me the 5th - 11th.

Being the walking bag of hormones that I am right now, I broke down in tears when I got home, partly because I seem to have babies at the wrong time in my families' lives, and I don't have as much of a support system built in here as I would like-- so I am freaking out a little as to whether or not I can do this. I talked to Matt on the phone, and he wants to see if he can switch his vacation-- it didn't help my morale when Matt said "I guess you're just going to have to go into labor your own during Dec 5- 11." I know he was trying to make a joke. The only reason I even considered an induction was so that I could have the baby when Matt would be around. I am normally dead set against inductions for convenience, but in this case I saw the benefit of having Matt's help. Now, I don't want to be induced as I think it would be completely selfish and self-centered of me to even consider it just so my kid doesn't have a "Christmas" birthday. I have to admit I was looking forward to being done two weeks sooner because I am already uncomfortable. I had cut back on my activity as it decreased the number of supraventricular tachycardia episodes which I had been having- haven't had an episode in a month. Now to stay sane, and get my self psyched up to go the full mile in this pregnancy, I am going to load up my calendar from here until Christmas.

To top it all off I had to wait another 30 minutes because I had to wait while the nurse figured out what was going on with getting me an appointment at the cardiology clinic. The OB is set on my getting into see the cardiologist.

All in all measuring just right- 29 weeks, blood pressure was fine, baby's heartrate was good.

Maybe I should just have a homebirth.... (this is the stubborn person in my talking) or take that nasty castor oil I did with Brigham come Dec 21st.

Sorry for the hormonal rant.....

Crystal

[Sheherezade]

You know - that just sucks. You'd expect a little understanding from someone just back from maternity leave. It's only a week before your due date. Are the risks that high? Sounds like she just got up on the wrong side of the bed this morning. I particularly like the guilt trip she put you on - worried about a Christmas birthday and "If your husband was shipping out to Iraq....".

Are there other doctors in the practice? I wouldn't want to deal with that attitude in labor. It could get dangerous. For her.

[PrincessFiona]

Oh Crystal Doesn't it sometimes feel that we women are our own worst enemies. Cynical me...but...you'd think she'd have more compassion...

Do you think Matt can switch his vacation? A friend of mine took the castor oil and was miserable...she didn't end up going into labor, but...she was cleaned out by the time that she did. :!

I hope your cardiology appt. goes ok and that things are feeling better soon. Before you know it, you'll be a mom again...and...you are going to manage it fine...really!

kris

[Amiens]

I guess the risk at inducing at 38 weeks is 5% for babies ending up the NICU. The doc said this is just too high. I thought what is 1 wk?! Apparently one week is a lot. I understood that anytime after 37 weeks was considered full term. Maybe someone who's spouse is OB can enlighten me.

I don't think she understands having a spouse in the medical profession and having two kids at home.
She just had her first...


Crystal

[PrincessFiona]

Wow...I didn't realize that either, Crystal.

kris

[Amiens]

Kris-

He's going to ask. It doesn't hurt to see if someone will switch with him. At least I know he will be at the same hospital as me when I deliver, if we by chance don't get the vacation switch. That's one less worry- I know the last two times it was a worry of mine whether or not Matt would be able to make it to the hospital, as with internship and residency he rotated between 5 hospitals. Luckily- Emma was born the last day of Matt's vacation during internship and was given 3 extra days by the department, and Brigham came the first day of his vacation.

Crystal

[Rapunzel]

My OB induced me this last time (with Eleanor) at 38 weeks. She considers the 37-38 week mark "full-term".

What I'd be interested in knowing (and, what I'd ask your OB, Crystal, if she were my docter) is this:

Is there a direct correlation between the time of birth (ie at 38 weeks) with having a stay in the NICU? It could very well be that this increased NICU rate is simply due to the fact that a baby in distress in-utero is more likely to be induced a bit early AND that baby in distress may be more at risk for NICU admission.

I guess I would really question the NICU admission rate being tied to the 38 week delivery by itself. I suspect it's a bit more complicated than that.

I've never had a problem with any of my voluntary-induction-friendly OB's having problems with inducing at 38 weeks.

Jennifer

[mommax3]

Crystal,

I will ask my husband for specifics, but I do know that he *generally* will not induce until 39 weeks, and then only if the cervix looks favorable.

You know, you CAN do this.....you will get through it, no matter how things work out, and it will be fine. I have always thought from your posts that you seem like an extremely capable person. I am sorry you had a crappy day!

Sally

[Vanquisher]

I was induced with both of my kids, one at 39 weeks and one at 36.5 weeks. I was sicker than crap, and my OB was a little reluctant to induce me at 36.5, but he did without much prodding. I had hyperemesis gravidarum and (TMI coming) wicked hemorrhoids.

On the morning of my induction my blood pressure went up A LOT. After I gave birth, my placenta was deteriorating and calcifying, and my baby was 7 lbs. 4 oz. With each new thing that happened, he kept saying how glad he was that he decided to induce me early.

I happen to think it is more dangerous to be overdue than a little under, but that's me, and stems from personal experience with a close friend and a family member. I told my OB under no uncertain terms that I would not be going late. Turns out, my crying in his office was good for something. Seriously, see if you can see a male OB in the practice and bawl your eyes out, that is if you can't get Matt to change his vacation.

And they can give you gel to ripen your cervix. They did with me on #1. I don't think I needed it with #2 (I was still pretty thick and like 2 cm dilated), but it went okay anyway.

[Phoebe]

I guess the risk at inducing at 38 weeks is 5% for babies ending up the NICU

Dh agrees with the 5% rate and said the rate of admission to the NICU is not due to being 38 weeks. After 37 weeks the baby is considered full-term and it wouldn't matter if you were induced at 37, 38 or 39 weeks.

Is there a direct correlation between the time of birth (ie at 38 weeks) with having a stay in the NICU? It could very well be that this increased NICU rate is simply due to the fact that a baby in distress in-utero is more likely to be induced a bit early AND that baby in distress may be more at risk for NICU admission.

DH's answer is the latter where the induction causes the uterus to contract and possibly cause a host of complications or distress for the baby such as cord compression and can even result in a crash c-section. The distress of the induction is what normally causes the admission to the NICU. I think more OBs are doing more inductions overall, so that may be a reason for the numbers of NICU admissions.

I was induced last time 5 days late for convenience sake and I don't think personally I would do it again. However, last time I was in your position being in a new place without a support system. It is stressful when you don't have control over when the baby comes. It seems like what you have written in the past that you have done well being augmented with pitocin. Like Nellie said, hopefully as the time draws near things will work themselves out. Maybe your OB was a little overwhelmed by just returning to work and wasn't as understanding of your situation as she could have been. I hope next time goes better.

Jennifer



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[Malpka]

Crystal,

I will ask my husband for specifics, but I do know that he *generally* will not induce until 39 weeks, and then only if the cervix looks favorable.


Sally

Same here, sorry.

I wanted to say, I truly feel for you. I also seem to have babies at a time that is terribly inconvenient for all parties involved With my first, DH had an in-service exam, and 2 other residents were to start vacation the week after my due date. I did not want to screw up DH's test, and I did not want to have people trying to double cover so that DH could take his whole 2 days of paternity leave . I was induced on my due date, which turned out to be a bad choice for me.

With my second, I was due in Thanksgiving Day, and all of our families were sitting around waiting to make their holiday plans contingent on my labor And again, there were issues with the schedule at DH's work. Well after the stress of last time, I just made a decision that I did not care. DH's job, my in-laws, and heck even my own parents have often inconvenienced me with things that were IN their control. Why am I making myself feel like crap because of something I have no control over? I went 10 days late, and was given grief the whole time (not by DH though, he was actually very supportive). I just made up my mind that I was not going to stress myself out and ruin my pregnancy by fretting about things beyond my control. Ultimately, my baby was born at just the right time for her, and I had a super easy labor and a great experience.

Totally easier said than done, I know.

I hope that things will work out for you in the way that will leave you as least-stressed as possible.

And again, there were issues with the schedule at DH's work. Well after the stress of last time, I just made a decision that I did not care. DH's job, my in-laws, and heck even my own parents have often inconvenienced me with things that were IN their control. Why am I making myself feel like crap because of something I have no control over?

Good for you! It is easier said than done but so true.

I would be upset, too, Crystal but I bet as you get closer some of these things will work themselves out -- change to vacation schedule, better appt with the doctor, etc. Hang in there. Big hug.

[Meenah]

Crystal,
I feel for you. I agree with all of the above. Things will work out, and your little angel will be here in her/ his own good time no matter what everyone else wants.
Luanne

[Amiens]

Thank you everyone! I am doing better now that I have vented here and of course Matt got an earful yesterday. I know the baby is going to come when he is good and ready. As I told Matt last night I think I had put all of my eggs in one basket that the doctor would agree to induce me during Matt's vacation, and when it didn't happen it was a huge let down.

Both times my labor has needed a boost of pitocin, so I figured the OB would be like "Oh sure, no problem! Let's do it this day." I am not going to fight my OB on this, I know that induction itself runs a slew of possible complications in itself.

I've pretty much decided I want things to run it's course. Based on the last two labors I have gone a few days early to on time. I made the mistake of not accepting the EDD given to me, and thought I was right not the 1st trimester ultrasound. Anyway, she was born at 39 weeks, just a few days before the u/s due date. With Brigham I accepted the EDD and he came on his due date.

I did get one piece of good news yesterday- the December schedule apparently is done, and Matt doesn't have to work Christmas.

Crystal

[BonBon]

Crystal, I'm sorry about that! Can Matt talk to her sometime? I usually have DH do the talking for me, and he knows which OBs in the practice are amenable to induction and who's not. (We're hoping to induce on the 28th at 39 weeks since he is on vacation then.)

Will Matt's partners work their post-call days so he can have off for a few days when the baby arrives?

Considering she just gave birth, I'm surprised she wasn't more sympathetic.