Plans A and B

The OB was actually helpful and informative yesterday. And even checked my cervix. I nearly giggled with joy when the medical assistant told me to undress from the waist down.

And at least now we have a plan. Well, two I guess.

Since my cervix was soft but still too posterior to even assess dialation, the OB was led to the assumption that I am not on the verge of labor. So we spent a considerable amount of time discussing the options. Again, these are the situations in which I really like my OB. She is very thorough and educated - in her answers, she always references data and how she reached her conclusions. I like that. And I know that is why Dr. Gentle recommended her to me in the first place.

Plan A: my body shifts into gear on its own before next Friday, October 10th.

Plan B: the check during my appointment on Thursday, October 9th reveals no progress from this week's check. I go into L&D on Friday morning to get checked again. If there is again no progress, the cervical ripening process will begin. The expectation is that I will hang out at home for most of the day and then return at regular intervals for checks and possible additional applications of the prostaglandins. I will check into L&D once I go into labor or on Saturday morning, whichever comes first. If there's no progress, they will begin to administer pitocin. The expectation is that I will give birth on Saturday or Sunday.

I was glad that I had thought through a list of questions ahead of time. Here's a quick summary of my questions and Dr. Smart's answers:

1) How safe is it to go beyond my due date and how does the fact that he's an IVF baby play into this? The fact that he's an IVF baby is actually great since we can be certain exactly how long we are exceeding the due date. The data shows that it is perfectly safe to exceed a due date by one week. After that, the risks (fluid levels, placenta health, etc.) go up. The OB - and the medical practice she works for - is not comfortable waiting until 42 weeks.

2) What drugs are used and how safe are they? The practice prefers to start with ripening agents (as opposed to pitocin) in the hope that it gives mother nature enough of a boost so that they won't need to use pitocin. They aim to make the experience as natural as possible. So, once the drugs kick my body into gear, I can proceed naturally. If labor does not proceed, then they will administer pitocin. When the OB said that they use Cytotec, I told her that I had heard that there were safety concerns (thanks, mrsprufrock!) so I needed her to speak to that issue. She said that they have been using it for 20 years and that the data shows the risk is for women who have uterine scarring. [I don't think that there is a way around using this drug so please be cognizant of this in your comments. If there are some tips/ things to watch out for, that would be great. I just don't want to get incredibly scared that it will kill me or the baby. I have started doing research on the internet but I don't want it to scare me further.]

3) Will I still be able to move around, take showers, sit on the ball, etc. to promote labor? Yes. I can try these options even if it means stopping the pitocin (if I need it.) They will unhook me from the IV and let me try these things. If labor again stalls, then I will go back to the pitocin. But, as long as there is no fetal distress, I can try all of the natural methods to promote labor. Also, if there is no fetal distress, I will not have to stay hooked up to monitors. I will only be monitored periodically.

4) May I still have a midwife? Yes.

5) May I still eat and drink during labor if I want to? Yes - unless I get an epidural.

6) Will getting induced increase my chances of C-section? The more resistant the body is to labor, the higher the chances. But that's not necessarily a direct result of the drugs. If the drugs work, then the answer is no.

I felt better walking out of the OB's office yesterday afternoon because at least we have a plan. Kind of like I felt while working with Dr. Gentle. It is good to have a date to aim for and to know what the possibilities are.

But I found myself awake most of the night worrying about being induced, grieving the fact that I might not be able to do the key things that I wanted to do in labor, scared of the drugs that will be involved, etc.

And I am exhausted today because of it. I am still hopeful that I will go into labor on my own, which is a possibility. But I am trying to prepare myself in case that doesn't happen.

I know that there are so many mixed opinions on this topic, but, honestly, I feel good about not going more than a day or two past 41 weeks. For me, I would rather experience the downsides of labor induction than endure the worry about LL's health.

The drugs scare me. I won't lie. But I keep telling myself that LL and I will be ok. I see an OB in a great practice who works in one of top hospitals in the Boston area. And that's all that matters. There are very few - if any - perfect birth stories and I think, inadvertently, that I had set my expectations too high.

As long as I can feel as in control over the decisions that are made during labor as possible, and I get to hold a healthy little boy at the end of the process, then I need to take the pressure off of myself and be flexible.

I was born hours after my parents' 4th wedding anniversary. Mr. LIW and I will celebrate our third anniversary on Thursday, October 9th. Maybe LL seeks to be the gift to us that I was to my parents. Honestly, Mr. LIW and I could get no better gift and we know it.