Thursday, April 21, 2011

the limbo rock

My weekly Kaiser Permanente prenatal newsletter reported in it's week 39 issue that most women give birth between 37 and 42 weeks of pregnancy.  There's a brilliant example of the precision of medical science for you.  It lists the dangers to the baby of going past 42 weeks, low amniotic fluid, the risk of meconium (baby's first poop) getting into the fluid and affect the baby's lungs, etc., etc.  Why is this important to me?  Right now I'm at 39 weeks and a few days.  My due date's officially on Monday.  Which is funny, because I don't actually hit 40 weeks until Wednesday; they moved my date up a few days based on how I was measuring at about 8 weeks.  Everyone's been assuring me I'll go into labor early or at the very least, on time.  But I have a sinking feeling that won't happen, even though this is my second pregnancy.  Julia was born almost a week late, and this was after a number of "natural" interventions meant to encourage labor: "sweeping the membranes," which sounds so gentle and is really quite horrible, as it involves the doctor putting her finger into my cervix and separating the uterine wall from the amniotic sac.  It was very painful for me, and the last time, they tried this twice.  Then there's castor oil.  I'm not sure what the medical uses ever were for this nasty stuff, as what it does for the expecting woman is give her violent diarrhea, which again, is supposed to stimulate labor.  In my case, it started light contractions that stopped after about eight hours in.  I thought my labor had stalled at that point, but my midwife told me I wasn't actually in labor at all.  My acupuncturist came to the apartment at that point to hit all the labor points.  Not sure if any of this did any good at all, except to make me (more) uncomfortable and frustrated. Ultimately, my water broke at 11:30 the following evening, which sent me rocketing through a four hour labor that was as close to hell as I hope I ever get.   All this, so I wouldn't have to go into the hospital for an induction, which my OB threatened would have to happen if I hit 41 weeks.  I think her exact words were, "We're not going to let you hit 41 weeks."  This echoes another passage from my newsletter.  Regardless of how the baby's faring (they make you go in for these tests beginning at 40 weeks to check on him), doctors will recommend an induction between weeks 41 and 42.  Regardless.  

Induction means pitocin.  Pitocin, a synthetic form of oxytocin is pumped into you.  The contractions are much worse on pitocin (not sure how that could be possible) making my goal of having a drug-free birth even more difficult to achieve.  But an epidural, its other risks notwithstanding, can also have the effect of slowing down labor.  And they'll only let you labor for so long.  You see where my mind goes. 

My friends who've had C-sections didn't choose to; they consented, of course, but the doctor made the call.  But I think it goes without saying that I don't always trust doctors to act in my best interest.  Even when they think they are, they're trained to think in terms of pathology, what's wrong with someone.  Often it seems that rather than let a natural process unfold, they'd rather go the shortest route to the end result to avoid possible complications.  So what does that mean for me, at 39 weeks and 2 days?  That if I don't go into labor on my own in the next four days, I start down a path that I don't want to go down.  I'll go in for my last prenatal appointment and they'll sweep my membranes.  I'll make subsequent appointments for non-stress tests and the like.  If I go a few more days, I'll have to make a choice about the other natural interventions.  I'll get more uncomfortable; I'll get more stressed.  At 41 weeks they'll schedule my induction.  So I'll get ready to fight, either my doctor for more time or my own body as it's taken over by pitocin-induced contractions.  Again, you see where my mind goes.

It's not my intention, however soap-boxy this may all sound, to judge anyone else's childbirth experience.  Healthy babies are born to happy mothers in many ways, and while I have a sense of what's right for me, I don't assume that it's right for everyone.  There are plenty of people, and in the Bay Area of all places, that think that my having a home birth with Julia was crazy.  I've met a good handful of people that think having a child without an epidural is crazy, especially when you've already had a natural childbirth that was as traumatic pain-wise as mine was.  But there's no other experience in life that's more personal than this, I think, no other experience where I've felt more compelled to listen to my inner voices rather than outside opinions, no other time when I've felt more confident that I know what's right for me, more than other women, more than even (gasp) a doctor.  

I'm steeling myself against the possibilities which are all quite daunting from where I sit.  And I'm steeling myself against them while trying to enjoy these last few uninterrupted days with my first born, trying to get another mouthful of breakfast in her before we go to the park, reading books to her about new baby brothers and sisters.  As always, I think worrying and overthinking is going to give me something I don't have under these circumstances.  Control.

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