Having baby! Induction readiness tests with diabetes concerns, labor & delivery
Pregnancy Tracker: 39 weeks
Size of the Baby: 8 pounds, more or less
Biggest Obstacle: Just a lot of anticipation!
Friday was my last day of work before starting maternity leave. The day flew by because we had a non-stress test and doctor's appointment in the afternoon. This would be my final set of appointments before the induction. It was a big day!
Quite an entourage joined the doctor, Dennis, and me in the exam room, including another OB, a nurse, and my Certified Diabetes Educator. Apparently they knew it was a big day too!
My doctor was focused on the baby's size, particularly whether the baby's belly had grown very much. We only had access to the regular ultrasound machine in the exam room, which is not all that precise. The two OBs measured the baby's belly three separate times to try to get an accurate picture of its size.
During this process, my doctor mentioned that our results could either be a "yellow light, a flashing yellow light, or a red light." As in driving, the yellow lights refer to various degrees of "proceeding with caution" and the red light means stop.
Initially, I thought he was discussing whether or not we'd still go with the set induction date. Meaning that if the baby's belly was large (red light) we'd induce, otherwise, we'd wait a bit longer to see if I went into labor naturally. After some more discussion, however, I realized that the doctor's light metaphor actually referred to whether or not he was going to let me even attempt a vaginal birth. As in, if the belly was really large (red light) then he would advise a cesarean section.
Luckily, after the three measurements, he declared, "It's a yellow light." So, we're going to proceed with caution and go with the induction on Wednesday morning.
The reason we have to be cautious is because the baby's midsection, particularly the shoulder area, could have difficulty making it through the birth canal. Therefore, certain interventions, like the vacuum or forceps could not be used due to risk of injury.
After we'd settled the question of Baby Bonilla's size, the doctor examined me to see whether or not I was dilated or effaced at all. I was pleased to learn that I was already 50% effaced and 1.5 centimeters dilated!
My doc remarked, "That's an inducible cervix!"
The third aspect of labor readiness they look for is called "station" or how far the baby has descended into the birth canal. Unfortunately, our little one hasn't dropped into the pelvis much at all yet. However, I am starting to feel achy in my hips and I've had a few, sudden, sharp nerve pains in my groin area. These are both signs that the baby is dropping and putting pressure on my hips.
So, the birth plan kicks into high gear Tuesday evening. Around 5 p.m., I'll call Labor and Delivery to see whether they have a bed available for me and what time would be convenient for us to arrive. Hopefully, we'll head to the hospital around 7 p.m., where we'll be admitted and they'll administer a treatment to "ripen" the cervix over the next 12 hours. My cervix should dilate a few centimeters during the night. According to the doctor, this procedure alone sometimes puts women into labor. He thought this could happen with me, since my cervix is already showing signs of early labor.
If labor doesn't begin by Wednesday morning, they'll start Pitocin intravenously. Additionally, I will have an IV of insulin and will disconnect my pump throughout labor.
I've been assured that the Pitocin will be administered gradually. Many women have horror stories of the contractions they experienced with an induction because doctors and nurses rushed the process to meet their own schedules. Thankfully, my doctor doesn't share that philosophy!
Another consideration is the epidural block. Since induction does bring on contractions that aren't "natural," I am more open to having the epidural. Also, since there's always the chance that the baby will be large and thus we'll end up having a cesarean section, I'm more inclined to get the epidural during the induction. Since c-sections are medicated through an epidural, if I already have one inserted, we can transition to the operation more efficiently.
I'm keeping an open mind about labor. It's funny how you can spend several months learning about labor and birth, yet there are still so many unknown factors. I know what possible scenarios I face, but I don't have a clue what will actually materialize as our baby enters the world. I'm focusing on going with the flow and trying not to be disappointed if things don't go as I'd hoped.
Ultimately, I know that I've done all I can to prepare my body for a healthy labor and delivery. I also have the utmost faith in my doctors, nurses, and the medical care I'll receive. We've purchased all the baby gear, read all of our birthing books, and getting our home in order for a relatively smooth homecoming for us and the baby.
There's nothing left to do but to have this baby!