Today someone other than me touched our baby's head. My midwife managed to get her finger clear through my cervix and into my uterus when she was giving me the 40 week internal exam. One the one hand, it's great that I am dilated and effaced and whatever enough that she could get one of her (admittedly teeny little) fingers in there, but on the other hand it hurt like stink. I am going to be a complete baby in labour.
The midwife and I talked about options if I go overdue, specifically if I get to the point where the baby's health is compromised and we have to move things along. Apparently I completely misunderstood my options as we discussed them before. I thought they would induce with prostaglandin gel but not with oxytocin, because oxytocin-contractions are too strong for my poor sectioned uterus. But apparently no, they won't use prostaglandin because once it's in you can't take it out, but (assuming they can find an OB who will agree) they will use very slowly increasing doses of oxy because it's easy to switch off should there be signs of trouble.
So if the time comes I can choose either another c-section or to attempt to labour with oxytocin. I am leaning towards the latter because I would like to give my body a fair chance to deliver a baby the old-fashioned way, and because I don't want to stay in the hospital for three days. We will see how it goes; not according to plan, that's all I know. Maybe I will spontaneously go into labour like a normally-functioning mammal!
I am now at the ten-day-countdown point. In ten days, this baby will be on the outside, one way or another.
My midwife has forbidden me to go into labour this weekend because it is her weekend off. She missed my last birth because she was my secondary last time, and apparently they don't call in the secondary for c-sections, so she will be really bummed if she misses it this time. Me too; I like our secondary but I would rather have Tiffany around for the birth, especially if it goes tits-up (so to speak). I know her better and we have built up more of a relationship.
Two internal exams and one unsuccessful attempt at a stretch and sweep later, I am still at one centimeter. The bad news is the baby went into retreat. Between the size of the baby (big), the state of my cervix (unfavourable) and the position of the baby (high) it's looking like déjà vu all over again.
Today I am going for the seven-days-post-dates ultrasound, where they will determine the state of my placenta and amniotic fluid, the size of the baby, and whether the baby is moving enough. This is the ultrasound which, last time, was the catalyst for going to the hospital for an induction. This time if I am sent to the hospital it will likely be for a c-section; between the previous section and whatever is wrong that they send me in for, I don't think any OB is going to agree to an induction.
Which leaves me in the position that at, say, nine o' clock tonight I will either be in a hospital bed recovering from major abdominal surgery and getting to know a new baby, or I will be at home watching What Not To Wear with my husband next to me and my first baby tucked into her crib a room away, and no doubt some ill-advised chocolaty treat.
One, or the other, and I have way of knowing which it will be. Do you have any idea how this blows my mind? I have to know what is going to happen in my immediate future, it's how I function. Also when I dropped Delphine off at daycare I didn't know whether I would see her tonight, or not until tomorrow or later. I just about cried.
Anyway, I woke up at 3:30 this morning and didn't get back to sleep because I was too busy thinking about all the things that would have to happen if I do get sent to the hospital. Possibly my last chance to sleep a full night for the next who-knows-how-long, and I blew it.
And the winner was... sitting at home watching What Not To Wear. The ill-advised chocolaty treat was brownies, which came with the even more ill-advised (but tasty) KFC we ordered after what was one of the longest, crappiest days I can remember.
After the 3:30 wake-up time, I spent my morning doing what I thought were last-minute housecleaning chores, and then headed downtown for the ultrasound. I didn't have time to take a nap, so I knew I was in for a hard day. The receptionist at the ultrasound lab was crabby and rude, and there was a two-hour wait for walk-in patients. Fortunately I had a book so the wait wasn't too excruciating, but the ultrasound was: the technician had me lying on my back most of the time, which really really hurt. She didn't seem competent; she made some ill-informed comments about the likelihood of me being induced versus having a c-section, and she didn't seem to understand the implications of a VBAC. Not that these are things an ultrasound tech needs to know, but you would think you would pick up a thing or two about pregnancy and delivery when you spend your days looking at unborn babies. Or at least you would keep your ignorance to yourself. She did a couple of other stupid things, but not worth writing down; suffice to say that I wasn't overwhelmed with confidence in the competence of the lab in general.
The protocol with this ultrasound is that if everything looks okay, they will send you home and send a copy of the ultrasound report to your midwife; if there is cause for concern they will page your midwife and ask you to stay at the clinic. They sent me home, but because I don't trust them I asked them to fax the report to my midwife that day instead of waiting until Monday. And then, after I left, I worked myself into a panic about whether everything was really okay -- maybe the technician screwed up the exam, maybe the doctor who looked at the report and gave me the all-clear screwed that up, maybe they wouldn't send the report to the midwife in time. I know perfectly well that if your amniotic fluid is too low or your placenta is too old your baby's life is at risk. There comes a point when it's safer out than in, by any means necessary, and I was far from reassured that I hadn't reached that point. And I guess I was so expecting to be sent to the hospital that I didn't really believe that the baby could be okay, that we could go home for the weekend.
I called Blake and made plans to meet for coffee at University and King, and then I bawled my face off all the way south from Dundas to King. Hiccups and sobs and everything. (I am so glad I live in a big city where you can make an ass of yourself and not expect to be seen by anyone you know, or be stopped by some concerned nosy neighbour.) When I met up with Blake he pointed out that last time we did the post-dates ultrasound, Delphine was nine days late, not just six, and she was still fine at nine days. He also said I should call Tiffany and get her to double-check the report just to be sure they didn't miss anything at the lab, which I did. (She said she would call back if there was a problem, and she never did.)
By then I was exhausted from lack of sleep, tension and crying, so I went home to pick up Delphine and put her to bed and relax. Unfortunately due to lack of communication with various family members I lost track of Delphine for almost an hour -- I was waiting to pick her up one place and she was someplace different -- which was devastating. I knew she was probably fine, but I was so tired and I wanted to see my little girl and go home. There was more crying. But we finally rendezvoused and everything was good again (apart from that she got to bed almost an hour and a half late).
I'm scheduled for a c-section on Tuesday afternoon. If I go into labour before then, that will be swell, but I am not expecting to, which I suppose is bad form and all, but I don't really care. I don't think mind over matter applies in this circumstance; if my body goes into labour it will do it whether I am pessimistic or not. I am just glad to have a date and time to look forward to, and a plan. On Monday I am going to the hospital to meet with the OB who will do the surgery, and then I'm going to see Tiffany to talk about the timing and stuff for Tuesday, and maybe try another stretch and sweep if I feel like it. Baby on Tuesday, back home by the weekend.
I didn't go into labour on Tuesday. I also didn't try the stretch and sweep on Monday because I missed Tiffany (she was at a birth, I was at home, I didn't feel like going out again.)
So Tuesday at 1:30 found us at the hospital. I got prepped: IV'd, cathetered, anaesthetized (just a spinal, like last time), and then we waited for about ten minutes while someone rustled up the surgeon, who was upstairs attending to another birth. They finally found her, and the festivities began. At 4:28 pm on September 27, 2005 Cordelia was born. Extracted. Whatever.
There was heavy meconium staining, and she had trouble breathing at first. Her initial Apgar was only 4, and she had to be suctioned twice before she breathed on her own. Her second Apgar was 9, though, so she pulled herself together pretty quickly. Regardless, she was in the resuscitation room for observation for a good hour before they brought her to me in the recovery room.
And that's pretty much it. There is not much to tell when you have a scheduled c-section. I stayed in the hospital for 48 hours (they let you go sooner if you are under the care of a midwife -- otherwise it would have been three to four days). The hospital sucked, just like last time; it was too warm, there was no place comfortable to sit (I could either sit on the bed, which got uncomfortable pretty quickly, or a hard waiting room-type chair), I was in a ward with three other, constantly changing, mothers and babies, the nurses were a crapshoot, some really nice, some awful. Ugh. I was glad to come home with my new baby.