Wednesday, October 21, 2009

The Mystical World of Membrane Sweeping and the Avoidance of Halloween

My 39 week appointment was on Monday of this week, and everything looks good- my belly is 39 cm., baby is moving, no protein in my urine, lost 1 1/2 pounds (which supposedly can be a sign that labor is coming), etc. I asked to have my membranes swept (or stripped, depending on what your OB calls it). I asked if the procedure usually works, and my doctor told me sometimes it does, sometimes it does not. Well, since I am 3-4 cm. dilated and 75% effaced, I thought it might just do the trick for me and send me into labor.

Well, first of all, the procedure, which is an internal exam in which your OB takes her finger and inserts into the cervix and sweeps it so as to disconnect the membranes connecting the cervix and gestational sac to release prostaglandins, is not pleasant. It is extremely uncomfortable. However, it does not last that long, and at the thought that I might have gone into labor from it, I was okay with the discomfort. (The only risk of this procedure is if your OB is not careful, she can snag your bag of waters, thus putting you "on the clock" and leaving you open to possible infection. There are really no other risks at all.)

So, what happened? I cramped, contracted, and could hardly move all afternoon. That evening I passed bloody mucus, and I thought maybe, just maybe, my water would break. Nope, no water breaking. Nope, no labor. Nope, nope, nope.

I have to say, though, that I have read lots of accounts of this procedure working, so do not take my story as the end all- be all of what happens if you get your membranes swept. I would do it again in another pregnancy with the hopes it could get things moving without a regular old induction.

So I'm still just hanging around, a full 39 weeks pregnant in my 40th week, wishing and hoping for things to get moving. If nothing happens by Monday, I have my 40 week appointment, and I will be having my induction scheduled. My OB practice does not let women go past 41 weeks, and since I am "favorable" with my current ripeness, effacement, dilatation, station, and position, I should be able to have mine at point from now onward. My husband and I are thinking we would like to schedule for little one's due date (the 28th) or the day after (the 29th) so as to avoid Halloween at all costs.

Avoiding Halloween? How dumb, I know. But here's the rub-- little kids LOVE Halloween. They love it so much, they have parties at school, and they trick-or-treat their little ghoulish hearts out... so frankly, I know my child's birthday will become indefinitely overshadowed by the boo-riffic holiday of Halloween if born on that day. I would like to avoid this. A birthday near Halloween is very cool... late October birthdays afford smashing Halloween-themed parties, and upon the ripe age of 21, an opportunity to celebrate ala Oktoberfest. So anyway, yes, I am being a nerd and absolutely unnatural if I reach my due date for the sake of keeping my son from having his birthday on Halloween. Judge if you like, but I think it makes sense enough, especially since my body is sitting on the verge of labor with a very likely successful induction in store.

Thursday, October 15, 2009

The Pregnancy Story (up until now...)

My husband and I were married in May 2008. I was told in college I had polycystic ovary syndrome and that it would be hard for me to get pregnant. While in school and before we got married, I lost around 50 pounds to make myself as healthy as possible. I was not as slim as possible, but the weight loss and healthier, more active lifestyle did improve my numbers. When my husband and I decided to prepare for trying to conceive, my doctor at the time suggested going off of birth control to see if my period could regulate itself without any medication. I went off of birth control, and my cycle was regular for three months. My husband and I were extremely careful while I was off of the pill for the first two months, but in the third we must not have been quite as careful because we conceived. We were not even really trying yet.

We found out and were overjoyed we were pregnant in late February 2009, and my due date was noted as October 28, 2009. The pregnancy was "normal" with the morning sickness and nausea that comes with the first trimester and the effortless weight gain and unwanted stretch marks of the second trimester. At our 21-week ultrasound, we were told we were expecting a boy, and we were so excited to hear that (we would have been happy to hear boy or girl)! We also were told that the placenta was low-lying at approximately 3 centimeters from my cervix, and if it did not move, the doctor recommended a C-section. I was put on pelvic rest (i.e. no sex in the champagne room) until a follow-up ultrasound could be done in the third trimester.

We moved from NYC to South Jersey in June. From that point onward, I was not actively working. We relocated mid-pregnancy because my husband had a great job offer closer to our family, and the cost of living would go way down from NYC. I switched to a new set of doctors in our new location. I was told by this practice that with the placenta 3 cm. away from my cervix, I actually could have a vaginal birth. The location of the placenta still worried me so I was scheduled for an ultrasound at 34 weeks.

At 33 weeks, we experienced one of the scariest nights of my life when we went into preterm labor. The day leading up to that evening I felt very off, I had extreme leg cramps, and I was exhausted. I took a nap in the late afternoon. When I woke up and went to the bathroom, there was the smallest spot of pink on the bathroom tissue. I was not concerned, but I called my doctor anyway just to be safe. She told me to come into labor and delivery as the OB office was closing for the day. She wanted to see "if I had an infection." When my husband and I got there, they hooked me up to monitors to find I was having contractions. They then checked my cervix, and I was told I was 3 centimeters dilated and 50% effaced. I was put on antibiotics, a fluid IV, and procardia (a smooth muscle relaxant). My fetal fibronectin test, which predicts the presence of a substance in your vagina that indicates the likelihood of labor within two weeks, was positive, and the doctors gave me the first round of steroid shots for baby's lungs over 24 hours. (It is important to note that a positive fFN is not indicative of imminent labor. Doctors look more for a negative result to be reassuring than for a positive result to be damning.) I was taken off of procardia after 24 hours because I had a strong reaction to it. The contractions slowed, but never stopped, yet my cervix did not change from the time I was admitted. No cause for preterm labor was found. I was sent home after 2 nights in the hospital on strict bedrest until 35-36 weeks.

At 34 weeks, we had our follow-up ultrasound, and we learned the placenta was way out of the way. We were also told our baby was growing right as he should, that his head was not too big (which is good for Mom), our fluid levels were excellent, and that the baby was practicing breathing while on the screen. This ultrasound put me at ease and excited me because I wanted a vaginal birth more than anything. Not only did I want the experience of a vaginal birth, but surgery terrifies me.

At 36 weeks, I was again permitted to live life as ever before, which I was quite happy to do. Bedrest is an extreme mental and emotional challenge. At my 38 week appointment this past Monday, I was told I was now 4 cm. dilated and 75% effaced. Most of the doctors and most of my family members, especially the women, cannot believe I am so dilated and thin with my first child and not in labor. I am contracting all of the time, and my husband and I are hoping our little son comes this weekend. If not, my doctor told me I can have my membranes stripped at Monday's (39 weeks) appointment and that I will be allowed to have elective induction around my due date due to my cervix being extremely favorable.

So now, we wait! And I must say, waiting is simply maddening. I am not the most patient person in the world, and it is very difficult to wonder when our baby is coming. Oh, and while I am at it, I will mention I have a mild case of PUPPPs, the mind-boggling and itchtastic skin reaction to stretch marks and late pregnancy hormones. I have had little blisters in my stretch marks, arms, and legs that are truly beyond tolerable. Luckily, hydro-cortisone cream and Benadryl are both safe to use for PUPPPs, and I have used them for relief. My rash is slowly healing, but the only true 'cure' for it is to have baby. So come along, baby, and let the real adventure begin!

Wednesday, October 14, 2009

...The First Post...

It's always a dreadful thing, writing the first post or the introduction to anything, because it is the creating of an initial looking glass to 'something' that has not yet taken form. So, welcome! Welcome to the blog I intend to keep. Welcome to my life as a soon-to-be Mom, wife, daughter, sister, writer, and you know, person. I promise my musings will be sincere, quirky, honest, varied, specific, and personal... or as much of those words as I can possibly be in this venue called a blog. Hopefully sometime there will be readers of this little space of internet, but there will never be readers without actual substance. So let's descend then, into the musings beyond this first post and end this little awkward introduction.
In all sincerity, welcome. I am excited to embark on this little diary-esque quest, and I hope you enjoy reading whatever comes to be written.