Friday, August 27, 2010

Dr. Appt: 38 Weeks

The stats:
Weight: gained 2 lbs (35.5 total)
BP: 112/80
James' heart rate: good

And the big news: 1cm dilated and 50% effaced!

Woohoo! I didn't make it that far for another two weeks last time. It doesn't mean we're headed to the hospital by any stretch, but at least this ol' reproductive system of mine is remembering what it's supposed to be doing.

Our discussion was pretty short with Dr. W. My only question was if there was anything we hadn't discussed regarding the birth plan that she might still need to know from me. She said she wasn't worried and felt she had a pretty good idea of what I wanted. She said we'd have time as things came up for me to express my wishes. She reiterated that her only requests are that I wear the hospital gown and have a hep lock in case of the need for an IV.

I asked again about the procedure once the baby is born, and we confirmed that yes, James will be placed on a towel on my stomach right after he's born. The nurses will do their Apgar scoring from afar while we get to hold our newborn! The umbilical cord will be cut when it stops pulsating (meaning it's pumped all the necessary blood into the baby), and then the nurses will take James for weighing, measuring, eye goo and shots. They'll hand him back to us, and then he's ours! I suppose at some point he'll go off for a bath, but I remember that being quite awhile after the fact with Caleb. So this is when I'll get the chance to nurse for the first time, and then the family will all be banging on the door to see the new baby. Hooray!

And then James will cry and I'll understand the true meaning of sleep-deprivation for the next two months...but I'm not thinking about that part!

Back to our appointment.... Dr. W said that if we hit 41 weeks like we did with Caleb, we'll do a non-stress test on James. If he's A-okay, then we'll just keep waiting. She said she didn't see any reason to induce except for the baby being in distress.

After we finished discussing with Dr. W, I was trying to form in my mind how to thank her for her openness to a natural birth and letting things happen on their own, when she beat me to the punch and thanked me for the same thing! She said most women are ready to induce before their due date and just get it done, and she said it was refreshing for someone to be willing to let nature take its course. I hadn't really expected that!

So that was our appointment. As patient as I want to be (and know I need to be), I get excited knowing that we'll have James soon!

Saturday, August 21, 2010

Dr. Appt: 37 Weeks

Weight gain: .5 pound (33.5 total)
BP: 124/80
James's heart rate: good
Uterus measurement: 35 cm

The uterus has gone from 36 to 34 to 35 in the last three weeks, so Dr. W says he's just sort of floating up and down a little, but his head is firmly engaged where it should be, so that's good!

Questions we discussed:
  • Sleep aids: High protein snack before bed, sleepytime tea, warm bath, heating pad on back. If at some point the early stages of labor begin but go very slowly (like they did with Caleb--two days of contractions for nothing), she'll prescribe Ambien, which she assures me will give me good sleep when I need it, but I will be awake and ready to go by the time contractions get serious.
  • Nursing mechanics: I had some difficulty nursing Caleb for the first few months, so we discussed some ways to avoid that, but it sounds like it just might happen again. Dr. W said that wearing "shells" and other devices before the baby is born really doesn't help change anything, and using the shields during nursing are really my best bet.
  • Tearing vs. epesiotomy: We brought this up again because when Dr. W asked me last time, I didn't really ask her opinion about it, and I wanted to know. She said that in fact the two heal just about the same way, so she didn't have a preference. There was one type of tearing that could cause some problems, but she said she could foresee if that was to happen and could avoid it with a small epesiotomy.
  • Any recommendations for preparing for the Big Day? Dr. W didn't have any prep ideas, but she did say to bring a robe, slippers, and my own sanitary napkins, as most women don't like the huge ones the hospital provides.

We also talked about a couple of random things:
  • Baby's equilibrium: The baby does not get dizzy in the womb because he doesn't have any muscle tone. Without muscle tone, he doesn't have the feeling of falling or being up or down.
  • Placenta history: Dr. Apgar (the lady who developed the Apgar score) felt that there was too much intermingling of blood between the mother and baby, so she was the one who started cutting the cord immediately upon birth, instead of waiting until the placenta had been delivered. Doctors no longer believe Apgar's reasoning, but the tradition still remains. Dr. W will most likely allow me to hold the baby on my chest for the final stage of labor. Once the placenta is delivered, she'll let Jon cut the cord if he wants to.

Does anyone else think that "placenta" is just a grossie word? Couldn't they have named it something else? Or perhaps the object itself would mar any name. It is weird, though, how that whole part of labor is pretty much ignored by everyone...even the nuts and granola home birth people pan away at that point in the video.

In other news, James is officially full-term! If he were born today, his lungs would be developed enough to make it in the world. We made it! Whew!

We have been very blessed by two baby showers--one at our church and one by mail--so we've gotten our final baby needs put together. Our carseat is being shipped (yep, that's what you do when you live in the sticks) and should get here this next week. I've packed a bag for myself and James. Now I just need to get a "labor bag" together, though hopefully I can do most of my laboring at home this time!

There are a few more things on my "need to do" list, but if they don't happen, it's okay. Jon and I are getting more excited about holding our new tiny baby boy. We aren't as nervous as we were last time. We have a better idea of how stinking hard it is in the beginning, but we also have a very real reminder every day of how wonderful being a parent is, and we can't wait for James to join the family!

Sunday, August 15, 2010

36 Weeks: Dr. Appt. and more!

Whew, these appointments are coming so close it's hard to keep up with them! Let's see if I can get you the highlights:

The stats:
Weight gain: 2.5 lbs
BP: 110/80
Baby's Heart Rate: "Just perfect"
Uterus: 34 cm

The uterus had measured in at 36 cm last week (so Dr. W tells me; I didn't get the measurement last week), which means the baby has dropped 2 cm! Hooray! I could tell something had changed based on my frequent trips to the bathroom, and sure enough, James is settled right on top of my bladder. His head is pretty set in the pelvis, so that's good! Hopefully he will stay there! Dr. W is estimating that he'll be about the same size as Caleb at birth, so around 7 lbs or so.

Questions we discussed:
  • Further clarification on the "natural methods of induction." It turns out that these methods (mentioned in a previous post) will start contractions, but will most likely not start labor. The contractions will serve to start the effacement/dilation process, something that didn't happen 'til late in the game last time. So when labor does begin, we'd be ready!
  • Birthing positions: It's common knowledge by now that trying to birth a baby flat on your back is not ideal. However, it's still pretty common practice. So when I asked Dr. W about different birthing positions, I was happy when she responded, "I'll use any position BUT flat on the back." She suggested a squatting position or even on all fours (I've read about it, but still not sure how that works). Something to note, though, is that an epidural effectively takes away the use of your legs, which means that an on-your-back position is almost required.
  • Video and photography is allowed throughout the entire process...if I really want it....
  • I found out that Dr. W will be attending the birth whether she's the doctor on call or not. This gave me a good bit of relief because I think she will be a big help, and by her admission, the other doctors in the group will probably only show up to catch the baby. She, on the other hand, will come around every 2 hours or so, day or night. She said the only time she won't come in is at the really tough part right before it's time to push (called the "transition phase"). While it seems a little odd, the reasoning is that at that moment, I will be begging her to do whatever she can to get. that. baby. out. Because I know she can. But if she's not hanging around (though she assures us she'll be close by at the nurse's station), I'm likely to be more patient and make it through that stage on my own. Interesting bit of psychology, eh?
  • Dr. W said that the nurses are very open to natural deliveries and will be just as willing--if the time comes--to act quickly for an epidural or whatever is needed.

All in all I thought it was an exciting visit. Not only does James seem like he's getting ready to go, I'm looking forward to working with Dr. W...and getting to hold our tiny baby in just four short weeks!

On from there, Jon and I headed to the hospital to pre-register and get a little tour of the Women's Center. The pre-registration was long, boring and expensive. Nothing to report. I was thankful my mom was in town and keeping Caleb at home!

The labor and delivery room is huge! When Dr. W told us we could have as many people in there as we wanted, I think it's actually true! We could fit a tight 30 people in there, I'm sure.

I asked about food and the nurse said, "You mean for him (Jon)? Because you're only allowed ice chips." I left that alone. Dr. W had said, "I'll deal with the nurses" regarding that issue, so I'll let her deal with it. The nurse said they provide a birthing ball, but they only have 2, and both were in use while we were there, so if we really wanted one, to bring our own. Good to know, because I LOVED having mine last time.

And then I confirmed that I could carry James out in my arms, which I can. Some hospitals require the baby to be strapped into a baby carrier, which we're not planning on having. And that was the basic hospital visit.

Overall I'm still feeling good. I have slight swelling in my ankles if I've been on my feet all day, but it goes down with rest. Yesterday we went to an indoor/outdoor museum that wore me out. I've definitely slowed down, but I don't feel bad. I'm sleeping much worse lately (Jon says I'm snoring up a storm, which I did with the first pregnancy, as well!). I've been waking up every couple of hours with my mind buzzing about baby stuff, then I go to sleep and dream about baby stuff. I don't feel any less comfortable than I have in the last few weeks, so I think the change in my sleep patterns is more psychological than physiological. However, I might try the couch tonight and see if that helps anything. At least it'll help Jon get a better night's sleep!

Thursday, August 05, 2010

Dr. Appt: 35 Weeks

Today was another doctor's appointment. I'll start going every week from here on out! It's getting exciting!

Here are the stats:
Weight gain: None this week. Holding steady at 30 pounds.
Blood pressure: 120/74
Baby's heart rate: 140 (The dr. checked it this time, so she actually gave me a number)
Uterus: Didn't take a measurement today

Though the Dr. didn't measure my uterus, she did check it out and confirm that James is in the head-down position! Hooray! She said it's very unlikely that he will move from that position, so that's good news! Babycenter says that James is about 18 inches long and 5.25 pounds. From here on out he'll just be packin' on the weight with not much more growth lengthwise.

I had a Strep test today, which is just a simple swab test of the vaginal area. If the test comes back positive, that means that James could contract strep as he passes through the birth canal, so they would put me on an antibiotic before delivery to avoid that.

My eczema is doing okay. The steroid cream is keeping the inflammation down for the most part, and the itching has become fairly minimal. My skin is starting to peel on the palms of my hands, but it's still minor right now, and hopefully it will stay that way! Dr. W said that if the eczema sticks around longer than 6 weeks after James is born, she'll send me to a dermatologist to make sure there's nothing more we can do.

We discussed labor options again today. I recently watched a documentary about hospital births vs. home births. It was very one-sided (leaning toward midwifery), but it showed me something I hadn't realized before: the Pitocin used to induce my labor with Caleb was probably what put him in distress, which resulted in a very harried (and hurried) delivery. Pitocin causes contractions to be stronger and longer, which is very hard on the baby. For some reason I hadn't put those two things together. So anyway, at today's appointment, I reiterated my desire to not be induced, and to avoid Pitocin if at all possible (many drs will prescribe pitocin to women whose labor began naturally but isn't progressing "fast enough" or whose contractions are erratic to regulate them a little more). Dr. W asked if that included using it after delivery (it's used to help the uterus contract back down and stop the flow of blood), and I said I thought that would be fine, since James would already be out.

Dr. W also asked me about the episiotomy, if I would rather the cut or to tear naturally. I had to pause about this one, because it sounds so much more in control to have a surgical cut. However, I know of several cases (including my own) where a cut has led to further tearing, excessive blood loss, or other complications. And recent studies seem to be indicating that a tear is actually faster to heal. So, I told her I'd rather the tear. Yikes! I'll have to do a little more research on the topic and make sure I'm certain about that decision.

My desire is the same as it was when I was pregnant with Caleb: I would like to stay at home as long as possible, and have as natural a birth as possible. That, of course, did not happen with Caleb, since we were induced and I checked into the hospital with barely a contraction in my belly. And it really seems that it was necessary to be induced (though I just spoke with a friend who self-induced with castor oil for all three of her kids, which worked like a charm and still allowed a natural delivery...wonder if I should have tried that). But Dr. W seems very fine with the fact that I want a natural delivery, and just emphasized that I need to be very clear about it to the hospital staff.

Perhaps because of our discussion about induction and Caleb's late arrival, Dr. W gave me a handout about "natural methods for induction" and suggested I start them at 37 weeks...starting slow and ramping up to 40 weeks. The handout included things like intercourse and using a breast pump. Well I gotta tell ya, I hadn't expected that! So I probably won't be keeping you apprised of that kind of stuff, but I thought it was interesting/funny that my dr. would pass on that helpful bit of information.

I won't get cervical exams until starting at 38 weeks, which somehow seems like a long way away! Not that I'm expecting anything, but it would be nice to know if there was any progress, and now I have to wait 3 weeks to find out. Oh, well! It'll all happen soon enough, I know!