Wednesday, October 21, 2020

Pop Goes The Preggo


One of the things this pregnancy taught me was that every time I thought I had an absolute, such as “I am never going to be induced,” I soon realized that life was determined to prove me wrong. 

Two days before my due date of May 15, I returned to Dr. Baby-Maker’s clinic. I hadn’t been back there since late January, well before the coronavirus outbreak, and it was all very eerie now. The parking lot was near empty. Signs warned that visitors were not allowed. There was even a checkpoint where you had to stop and get quizzed about where you were going and if you’d been exposed to, or had symptoms of, coronavirus.

A sole receptionist manned the clinic desk behind a massive Plexiglas shield. The waiting room looked like it had been robbed; there were only a few chairs, substantially spaced out throughout the room. All the newspapers and magazines were gone. Every day since coronavirus arrived in Minnesota felt more and more like a sci-fi movie.

First on the appointment agenda was an ultrasound. The sonographer confirmed that I had the minimum amount of amniotic fluid necessary for “this far along” in the pregnancy. The baby was way too big for any glamour shots, so the sonographer focused on gathering measurements of the head, femur bone, and abdomen. According to the machine’s magic math, my due date would be May 18, which was odd, since the baby had been measuring ahead of the due date for most of the pregnancy.

Then it was time for the baby's weight estimate. I was worried that with each passing day, the baby was getting too big to birth vaginally. The sonographer did not assuage this fear.

“Nine pounds, 10 ounces!” she announced.

“Oh, no,” I said.

“But these estimates can be off by 15 percent in either direction,” she added. If the numbers skewed lower, that would still put the baby at 8 pounds, 1 ounce, which wasn’t the biggest baby I’d ever delivered (my first was 8 pounds, 4 ounces), but it was pretty big for a girl.

While waiting for Dr. Baby-Maker in an exam room, I texted my family about the baby’s weight.

“OOF!” my younger daughter replied.

“Can we get an F in the chat,” my older daughter said.

At this rate, all the newborn clothes I’d purchased for the baby would be too small by the time she arrived.

Dr. Baby-Maker entered the treatment room, donning a face mask and shield. It made her appear slightly more serious than usual. I explained that I’d transferred to the birth center in the hopes of having a natural birth but that now I just wanted to deliver the baby by any means necessary. 

“I can imagine,” she said. “This is the longest you've ever been pregnant!”

Finally, someone understood. I wasn't just being impatient. 

“I’m willing to induce you,” she said. “I could do it as soon as Friday if you want.”

There was just one hitch – my cervix had to be ready. Dr. Baby-Maker put on gloves and did an internal exam. I stared at the ceiling and hoped for good news. She seemed to be really digging deep inside of me. This didn't bode well.

“Your cervix is completely closed,” she said, and snapped her gloves off. “I tried to see if I could get even a fingertip in there, but nope.”

Because of my “unfavorable cervix,” Dr. Baby-Maker couldn’t do an induction until I reached 41 weeks. That would put us at May 22, over a week away. It felt like forever. How much bigger would the baby be then? Would she even fit through the birth canal?

“Come back early next week,” Dr. Baby-Maker said. “We’ll do another ultrasound and cervical check.”

I wasn’t happy about having to wait, but at least this plan would put me a few days ahead of the birth center protocol. With the latter, I wouldn’t even get induced until May 26, and their methods (castor oil smoothie, herbs, amniotomy) could take days to get labor going. Given the baby’s size, I might very well end up transferring to the hospital anyway.

“I may have to accept that this won’t be a natural birth in any shape or form,” I wrote in my journal. “I think I can accept that. I might even be willing to do the epidural if the pain is too much. Oh, Lord, please let the birth be gentle and safe, no matter how it happens.”

Later that day, my daughters and I joked about how the baby was going to be so mature by the time she was born that she was just going to walk right out of the womb and say, “Hey, mom, give me the car keys. I’ll drive myself home.” Or: “Hey, mom, what’s the Netflix password?” There were endless punchlines to this joke.

The next day, I registered with the hospital for the induction and scheduled a coronavirus test (per the hospital’s protocol). Then the birth center called.

“We had a meeting to discuss our induction policy,” the midwife said. “And we believe you’re a good candidate for induction. We’d like to offer that for you if your cervix is ripe.”

The timing of this offer was very suspicious. Why was I suddenly a “good candidate” for induction when I’d been so harshly turned down just days before? The birth center knew I was transferring care because I’d requested to have my records sent to Dr. Baby-Maker. I suspected the only reason the birth center was offering induction wasn’t because it was best for me and my baby, but because birth is big business and if the midwives didn’t induce me, they knew they would lose me as a “customer,” and therefore forfeit thousands of dollars in insurance payments.

I explained that I’d already visited Dr. Baby-Maker, that my cervix was not ripe, and that I was scheduled for a medical induction at the hospital on May 22. I didn’t see what else there was to discuss.

“If you come in on May 21, we can check your cervix, do a stress test, and then induce you,” the midwife said.

The birth center was like a bad ex-boyfriend I couldn't say no to. I reluctantly agreed to the appointment, but I kept my hospital induction appointment, too. I could always cancel either – or both, if I went into labor spontaneously before then.

“My hope, and prayer, and wish, is that I will just go into labor on my own before any of these appointments have to happen,” I wrote in my journal. “You’ve got three days, little baby, before we get on this non-stop train to induction, which could end any number of ways. God help us both.”

My due date came and went. At my follow-up appointment with Dr. Baby-Maker, an internal exam revealed that my cervix was a “tight 1” but that I had effaced 80 to 90 percent.

“You never know,” Dr. Baby-Maker, ever the optimist, said. “You could still go into spontaneous labor before the induction!”

I smiled weakly in response. I’d given up hope that the baby would come on her own. 

Dr. Baby-Maker walked me through the induction plan: in two days, I would check in at the hospital at 7 p.m. I would be given a cervical softening agent, followed by Pitocin. The baby would be born sometime the next day, likely in the afternoon. My husband could stay with me throughout delivery and recovery, but once he entered the hospital, he was not allowed to leave.

“Is there any reason that we might schedule a C-section instead, given the baby’s size?” I asked.

“No,” Dr. Baby-Maker said. “The baby would have to be measuring 11 pounds for us to have that conversation, and even then, I’ve delivered many big babies vaginally. The only reasons this might end up as a C-section is if you labored to, say, 5 centimeters and then stalled for a long time, if the baby’s head wasn’t moving down the birth canal fast enough, or because of shoulder dystocia.”

Though I’d doubted Dr. Baby-Maker’s competency and experience in the past, I now felt fully confident in her abilities. And while I was disappointed that I wasn’t going to go into labor spontaneously, I was glad that Dr. Baby-Maker would be attending the birth. I couldn't think of a more enthusiastic person to deliver my baby. 

I headed home, had lunch, then set off for a walk with my husband and my daughters. We’d increased our walking frequency lately in hopes of encouraging the baby down and out. It seemed to be yet another old wives’ tale that didn’t work.

Until it did.

Only a couple of blocks into the walk, I felt a huge gush of fluid between my legs. It soaked through the pad I was wearing. My water had never broken on its own (I had amniotomies with my previous births) so I thought I’d just peed myself yet again. We continued walking, but then the contractions started – contractions so painful I had to stop and catch my breath. My younger daughter timed them. Three minutes. Two minutes. Was this it?

At home, I got a hot pack for my lower back and assumed a position on all fours, but the contractions strengthened, to the point where I couldn't talk while they were happening. It was like being slammed with waves of pain. I barely had time to breathe and regroup in between.

It was decision time. Birth center or hospital? Who you gonna call?

“You were just here!” the nurse at Dr. Baby-Maker’s clinic said when I gave her my name over the phone.

“I know,” I said. “But now I think I’m in labor.”

I explained my symptoms and she told me to head to the hospital. I was ecstatic. It seemed I wouldn't have to be induced after all...

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