UPDATE!! My 41-week appt... feeling a little anxious

[justineybean]

UPDATE: Thanks mamas, for all of your positive thoughts and encouragement. I wanted to let you know that my baby arrived Thursday morning at 10 lbs 2 oz with no issues whatsoever. The birth was absolutely perfect - she arrived on her own with only 30 minutes of pushing. I plan to post the whole story when I can bring myself to put her down. Thanks again

OP:
I just had my 41-week checkup with an NST. The baby's heart rate was great during the monitoring and the u/s went fine - plenty of fluid, baby is making breathing movements, moving in general. They estimated the weight at 10 lbs. (although I think she measured twice and the 1st measurement said less) which I know can be +/- a pound. My DS was 9 lb. 4 oz. a week after being estimated to be at 9 lb. 10 oz.

The frustrating part... The CNM offered to induce me tomorrow even though we already discussed waiting until closer to 42 weeks. I am 3 cm and mostly thinned out and had my membranes stripped. So hopefully I will go into labor on my own. Then I met with the OB and she wanted to tell me the risks of going further post-dates with a (probably) big baby. She starts with shoulder dystocia and risk of birth injury then talked about the placenta not providing enough blood flow to the baby as it gets "old." She said it was my "right" if I wanted to have a c-section so I can avoid those risks. I declined and she did not press it with me but when I asked her if she felt good about the plans we made she just said "I'm a doctor, I like to be conservative because I see bad things happen..." I wanted to cry. Of course I don't want to put my baby at unnecessary risk and I don't plan to go past 42 weeks (I agreed to be induced if I haven't had my baby by next Tuesday - I'll be 42 weeks on Wednesday).

I was just a bit disheartened. I know you can't always get the support of your care providers and have to go with your gut but I felt like she was trying to scare me and also she did not discuss any of the risks of being induced or having an elective c-section.

Thanks for listening. I just want to be patient and give my baby time to come on his/her own terms.

[jessica_m_b3]

I hope that they come out on their own soon!! Good luck!

[Ola_]

Actually I think shoulder distocia is a higher risk with a malpositioned baby than with a bigger baby. And the ultrasound estimates are not a pound but up to two pounds inaccurate! I'd work on optimal fetal positioning and do some spinning babies stuff if you're not already - getting that kiddo in the best position possible will get the head to press on your cervix better and can help get labour going!

[justineybean]

Thanks to both of you for the encouragement - I am checking out spinning babies now.

[TwinKristi]

Well unfortunately that's what OBs usually see. High risk patients, worst case scenarios and scary deliveries. They don't weigh the odds of induction or an elective c/s because their ultimate goal is a live baby and mom even if that means cutting mom from hip to hip to get the baby. KWIM? I would have asked her what the risks associated with an elective c/s or induction is. I know that my old MW gave me so much crap about wanting to induce at 40w3d saying it was dangerous and how much pain I'd be in. The week before they almost lost a mom during a c/s after an elective induction gone bad. Those are things an OB never says! LOL
You have to go with your gut and do what you feel is right. Talk to your dh, talk to your MW and go from there.
My friend lost her baby in March at 42wks during delivery due to cord compression, which is another risk of going post date. She waited it out and cancelled her induction 5 days earlier to give her body more time but ultimately she was induced at 42wks. Her induction was long and hard, baby had decels and they lost him during the last 5 mins. Who knows if inducing at 40-41wks would have made a difference, she will never know.
I know a mom's birth experience is a major thing and something you have to live with and accept, but ultimately a healthy baby and mom is what everyone wants. Baby may be tolerating pregnancy but tolerating labor & delivery is something else.

[Hillargh]

She has to say that mama. Medical professionals can't give any indication of their personal comfort level or preference in situations that could sway you for liability reasons. I'm sure that's what she meant If she were to say "I think you're making the right choice," and something were to go wrong, sue-happy society says she'd get screwed, kwim? She has to present the facts, options, and go with what you want.

However, I completely understand how discouraging that can be. I'm sure that if you have confidence in her abilities, that she would pipe up and strongly recommend a section if that's what seemed the best route right now. No one is going to sit by if they believe your choice is putting the baby in danger, if only for the same reasons I mentioned above, kwim?

I hope your LO comes soon, and everything goes wonderfully for you

[justineybean]

Originally Posted by TwinKristi Well unfortunately that's what OBs usually see. High risk patients, worst case scenarios and scary deliveries. They don't weigh the odds of induction or an elective c/s because their ultimate goal is a live baby and mom even if that means cutting mom from hip to hip to get the baby. KWIM? I would have asked her what the risks associated with an elective c/s or induction is. I know that my old MW gave me so much crap about wanting to induce at 40w3d saying it was dangerous and how much pain I'd be in. The week before they almost lost a mom during a c/s after an elective induction gone bad. Those are things an OB never says! LOL You have to go with your gut and do what you feel is right. Talk to your dh, talk to your MW and go from there. My friend lost her baby in March at 42wks during delivery due to cord compression, which is another risk of going post date. She waited it out and cancelled her induction 5 days earlier to give her body more time but ultimately she was induced at 42wks. Her induction was long and hard, baby had decels and they lost him during the last 5 mins. Who knows if inducing at 40-41wks would have made a difference, she will never know. I know a mom's birth experience is a major thing and something you have to live with and accept, but ultimately a healthy baby and mom is what everyone wants. Baby may be tolerating pregnancy but tolerating labor & delivery is something else.

Thanks for your response and encouragement! You highlighted some of my worst nightmares and worries. I think the doctor and I have the same interest at heart - that my baby be born healthy and happy. Although I want a natural birth, it is not controlling my decisions in the least. I am not as concerned about my birth experience as my baby's well-being... I think that waiting is best for my baby and I instead of inducing or having a c-section. I just don't think I have reason to believe otherwise. I know bad things can happen at any stage in pregnancy or during any birth but ultimately risk statistics just don't mean much to the individual who loses their baby. I guess that's why I'm having such a hard time not worrying... sigh. Thanks for listening.

Originally Posted by Hillargh She has to say that mama. Medical professionals can't give any indication of their personal comfort level or preference in situations that could sway you for liability reasons. I'm sure that's what she meant If she were to say "I think you're making the right choice," and something were to go wrong, sue-happy society says she'd get screwed, kwim? She has to present the facts, options, and go with what you want. However, I completely understand how discouraging that can be. I'm sure that if you have confidence in her abilities, that she would pipe up and strongly recommend a section if that's what seemed the best route right now. No one is going to sit by if they believe your choice is putting the baby in danger, if only for the same reasons I mentioned above, kwim? I hope your LO comes soon, and everything goes wonderfully for you

You're right - I'm sure liability plays a big role and she can't really tell me that my decisions are right. But I also feel confident that if there was a really major concern that the OB would definitively recommend an intervention to reduce risks. Thanks so much for your kind words.

[Greenbabybottoms]

Originally Posted by justineybean You're right - I'm sure liability plays a big role and she can't really tell me that my decisions are right. But I also feel confident that if there was a really major concern that the OB would definitively recommend an intervention to reduce risks. Thanks so much for your kind words.

I can tell you that I am being faced with an induction at 39 week or c section at 39 weeks option. I asked my midwives what they thought the best option was and got a very vague "If we only had a crystal ball we would tell you what the absolute best option is but all we can do is tell you the risk of each". It was frustrating but I do think it's so much about liability. They did say that if they truly felt that one option or the other was harmful they would come out and say if there was a real concern. I do know how frustrating it is though when you just really want them to tell you what they are thinking!

[yellowitchgrl]

If you have a shoulder dystocia you get onto your hands and knees and the baby can be guided out.

Bigger risk of a c/s with an induction. Everything says that. Go on several long walks and skip the induction.

[songbird516]

Originally Posted by justineybean I just had my 41-week checkup with an NST. The baby's heart rate was great during the monitoring and the u/s went fine - plenty of fluid, baby is making breathing movements, moving in general. They estimated the weight at 10 lbs. (although I think she measured twice and the 1st measurement said less) which I know can be +/- a pound. My DS was 9 lb. 4 oz. a week after being estimated to be at 9 lb. 10 oz. The frustrating part... The CNM offered to induce me tomorrow even though we already discussed waiting until closer to 42 weeks. I am 3 cm and mostly thinned out and had my membranes stripped. So hopefully I will go into labor on my own. Then I met with the OB and she wanted to tell me the risks of going further post-dates with a (probably) big baby. She starts with shoulder dystocia and risk of birth injury then talked about the placenta not providing enough blood flow to the baby as it gets "old." She said it was my "right" if I wanted to have a c-section so I can avoid those risks. I declined and she did not press it with me but when I asked her if she felt good about the plans we made she just said "I'm a doctor, I like to be conservative because I see bad things happen..." I wanted to cry. Of course I don't want to put my baby at unnecessary risk and I don't plan to go past 42 weeks (I agreed to be induced if I haven't had my baby by next Tuesday - I'll be 42 weeks on Wednesday). I was just a bit disheartened. I know you can't always get the support of your care providers and have to go with your gut but I felt like she was trying to scare me and also she did not discuss any of the risks of being induced or having an elective c-section. Thanks for listening. I just want to be patient and give my baby time to come on his/her own terms.

This so me is very frustrating, because as you already said, there are risks with inductions and c-sections, but she didn't mention those.

Chances are, your body will go into labor and you will be able to birth a healthy baby. Keep that in mind, and if you really get concerned, if your mother instincts start going off, then consider inducing. Otherwise, it sounds like your baby is fine. There is a higher risk of shoulder dystocia during an induction w/ epidural. Bigger babies need moms to be mobile so that they can work through the pelvis- that's what it's designed for!! Stay positive and keep telling yourself that you can birth the baby that your body grew. You need to give your baby and your body the best chance of working together, and inductions make that much harder.