I've had some blog ideas neatly organized in Evernote (whom I love dearly and yes, my ever reliable Evernote is a person to me.) I was flipping through them today since I felt like writing and had a quiet moment. I saw a note on my list about doing a baby update. I scrolled through my blog posts with the sinking realization that I had not updated my nearly non-existent and mostly hypothetical blog audience that H4 will be joining our family in early December. Whoops.
So, to my dear sweet H4, Mama is sorry! Failing to blog about you does not mean I love you less. If you read this years from now, please know that I totally made you "Facebook Official" when we were nine weeks pregnant and you are the subject of many status updates, text messages to Grammie and conversations between your siblings. (They are FASCINATED with you and very excited to meet you!) Also, please know that practically anyone that reads this blog already knows me and is probably related to us or on my Facebook page.
We're in Week 30 or 31, depending on who is counting. The calendar method used by the US doctors puts me at 31 weeks. The ultrasound and common-sense approach used by the German doctors says 20 weeks. One week difference doesn't sound like much, but with this pregnancy it is! I prefer the later due date since I know my track record with having babies on or before my so-called due date is nil. I've shown up for my 40 or 41 week checks with the midwife and she's found a "Gone Fishing" sign on my uterus. Really, we don't "progress" well. I'm also in favor the later due date because the doctors I'm seeing here in Kansas are strongly pushing for an early delivery.
The difference between the German OB and the US OBs is remarkable. The German OB was pretty much unconcerned about my prior placental abruption. His words were "Well, yes. That is a small risk. It will happen or it will not happen, but we can't predict it or stop it. We'll just treat it quickly if it happens and you know the signs now so you'll know what is happening." End of story. The OB practice here in the States is much more concerned about what happened. They've been over my medical records, ordered a bunch of tests, asked me a million questions about my history and came to the definitive conclusion that they have no idea why it happened. On one hand they say the risk of a second occurrence is nearly as small as the risk the first time and there's no reason to expect it will happen again. On the other hand, it happened and they don't know why, so they're afraid it might happen again. Personally, I think I prefer the German attitude.
The OBs are really pushing me for an early delivery. They say that in terms of risk management, it's important to avoid the time frame of the last abruption. (Mine was at 40 weeks and 4 days, pretty late in the game! A real blessing for DeeDee, so at least she was a big, strong, well-developed sick baby!) Depending on the doctor, I've been pushed for a scheduled c-section as early as 38 weeks and as late as 40 weeks. One of the providers is willing to attempt a VBAC with me but still wants to induce early. (More on the VBAC induction later!) The doctors have said their practice is "very conservative" which I take to mean "highly risk averse." They very much prefers the control and "neat" approach of scheduled c-sections for repeat offenders like myself and especially one with an abruption and large babies in her medical history.
The doctors may think I'm unimpressed by the risk or severity of what happened since I am highly resistant to their risk mitigation efforts. The reality is that both Soldier and I have had a very strong conviction that H4 belonged to our family well before he was conceived. We struggled with the risk, the fear and worry for months before obeying. So, in a nutshell, we're over it. I firmly believe this will be a nice boring pregnancy and delivery and that H4 and I will come through safe and sound. From a logic standpoint, I don't see the need to worry about an outcome the doctors have said is so unlikely and minimal. I think H4 is probably safer in my belly until he's good and ready to come out than pushing things to happen earlier than necessary.
For now, I'm sticking with an OB in the practice that seems more willing to compromise and is frank about her concerns and struggles in weighing my risks and delivery plans. We've struck a compromise on the due date: halfway between the later due date I prefer and the earlier calendar-method due date. She's also on board with attempting a VBAC with me and waiting to attempt an "induction" until our compromised due date, which I appreciate. I'm still not entirely on board with this plan since the "induction" isn't a true induction. Apparently, the cervical gels and pitocin drugs are not used on patients with prior c-sections. So, the plan is to break my water and wait 24 hours in the hospital and see if any contractions start. If contractions start on their own, small doses of pitocin are used to "augment" labor. There are two problems with this plan, as I see it. One is that I have to be somewhat dilated (The OB is hoping for a good 3 cm) to break the water. My track record for dilating early is seriously NOT good. (Remember the "Gone Fishing" sign?) The other problem is that once the amniotic membrane is ruptured, there's pretty much a countdown started on delivery. 24 hours is generally the benchmark for a decision. If I'm not in some hot 'n heavy labor by then, they will move to a c-section because of the risk of infection from the open amniotic sac. (This risk, by the way, is highly debated in natural birth circles and is not conclusive, in my assessment.) So....I feel like there's still a very good chance that I could end up on the OR table. I was NOT a fan of the first c-section and I really don't want one again. (Really....I feel like that should be saved for a life or death situation!)
So, there's the baby update for 30 or 31 or 30.5 weeks and counting! Everyone is happy and healthy. I'm confident and calm most of the time, but I have made sure my Living Will and Medical Power of Attorney papers are up-to-date and accurate. I've also used this as an opportunity to teach MonsterBoy some "Emergency Preparedness" skills like reciting his home address, dialing 911 on the house phone, dialing Soldier, Grammie or Grandpa on my cell phone, etc.
And to Baby H4....We love you and can't wait to see your sweet face! (We know he's a BOY but he hid is face very well in every ultrasound!)
