Reflections on Ethan's birth - Part 2 - the "Big Baby" scare & choosing induction

[MamaSueCongdon]

At my next visit, which happened to be that next week, my NP had no idea I’d been to L&D. I mentioned it, and she clicked into my file and finally saw all of my visits to L&D, as well as all of the NSTs. She was surprised, and didn’t hide that this was the first time she’d seen this information. She continued with the exam without mentioning another word. I measured big – again – and she sent me home – again – to wait for another call from the ultrasound techs to schedule a screening to check for something that she didn’t explain. When I went in for the ultrasound, I was absolutely miserable on my back. I watched the ultrasound tech do measurements of my son, three or four different times. Then she left the room but instructed me not to move until she got back. I defiantely rolled onto my left side and tried not to cry. When she came back, she repeated the screening and left again. I got dressed and decided I was done with whatever was going on. When she came back, she looked scared and told me to walk over to my NP’s office to discuss the results. I wobbled my worried and very pregnant self down a very long hallway, across a large parking lot, and upstairs in the next building and waited. A half hour later I was called in to sit in her exam room for another fifteen minutes. I was getting really scared, and still didn’t understand what they were looking for in the ultrasound.

When the NP finally walked in, she was grey. Her face was literally grey, and she was fidgety and wringing her hands. She sat down on a stool in from of me and took about two minutes to explain that my son was measuring four weeks ahead of his EDD, which meant he was probably going to be around 11 lbs if he was born on his due date. She told me that she’d arranged for me to meet with an OB to talk about having a c-section, handed me a “risks of c-section” handout, and left the room. My head spun – I purposefully did not pay attention to the c-section day in our birth preparation class because I did not think I’d ever end up having one. I couldn’t imagine being awake while someone cut me open. When I got home, I started researching. I didn’t get very far before finding the ACOG guidelines stating that elective c-sections should not be offered for fetal macrosomia because it doesn’t change outcomes. I found a couple message boards where other Moms had asked about this very thing, and got the impression that doctors like to schedule c-sections for convenience and as protection against litigation should they injure your baby on the way out. And I learned that an equal number of babies in both the “large” and “small” category get stuck and injured. I went to my first OB appointment feeling defensive, untrusting, and angry.

The OB disarmed me with her politeness. She calmly explained that with large babies, there is a risk of shoulder Dystocia, and that when this occurs care providers get very scared and may end up having to break the baby’s arm in order to keep the baby from suffocating and with getting major brain damage or even dying. I asked her what risks a CS would pose to the baby. “None,” she said calmly. But I knew from my research that there were risks… like the potential that the baby could have respiratory problems, or get injured, or even the real possibility that he could die. My distrust of this hospital – which had started with the rude secretary who ignored me while I stood in front of her desk to ask where I was supposed to put my pee cup during my first visit, grew during the comedy-of-errors that I encountered each time in my L&D scares, and discovering that they were prescribing potentially dangerous drugs to me – off label – when they knew it wouldn’t stop TRUE pre-term labor – was completely solidified. I had a couple more visits with the OB – two different OBs actually… because neither of them had time to add me to their schedules on a regular basis. Both of them smiled politely and told me that “it was great” that I wanted to “attempt a trial of labor” and that it was up to me to decide how much danger I was willing to put my baby in .

My NST appointments over the next couple of weeks got progressively discouraging. I’d been given a condescending “okay” from the OBs to “have a trial of labor” but apparently someone added notes to my file about the baby’s size. My favorite nurse tried to hide her surprise at my son’s increasing size as the next few weeks wore on. The second nurse that I’d grown to like, kept expressing her shock at how HUGE my baby was. I knew that the facts supported my decision to at least try birthing my baby vaginally – but all of the seeds of doubt took hold in my heart. I stubbornly dug my feet in and tried to do more and more research. I tried talking with my husband, Mom, grandmothers, friends, and mentors to try and get their support as I told them what I’d learned. Most of them were relatively supported, “you never know until you try!” but they’d always add, “you need to be prepared to do a CS if it’s necessary…” or “of course the most important thing is having a healthy baby.” I took their doubts personally – of course I want what’s best for my baby… right? That’s why I’m not consenting to this surgery. I was insulted that they would assume that a healthy baby wasn’t my first priority. And all of these feelings mingled together with all of the feelings of fear, bitterness, and shame that’d I’d been marinating in throughout my pregnancy. I still didn’t feel ready to be a mother, and felt alienated from this baby, and I sure as hell wasn’t consenting to major abdominal surgery just because my stupid doctor was scared of being sued.

One night, I was having a hard time getting comfortable and was resting with my hand on my tummy. I felt a familiar kick near my belly button, right where my hand was. I pushed back, and felt the outline of a foot! I traced the foot with my finger and gently pressed on it. My son took his foot away and “hid” for a moment, and then playfully kicked me! I laughed out loud at our little came, surprised to be bonding with my son for the first time. I remembered one of our ultrasound photos showed Ethan with his foot pressed against my belly. I ran into the living room and dug through my purse to find the ultrasound – and there it was! A picture of the little foot I’d been playing with. I was finally truly connecting with my son for the first time, and enjoying the playfulness we were enjoying. It was then that my fears took hold with a vengeance. For the first time, I fully wanted this baby – and even the smallest possibility that he could be hurt rocked me to my core. I’d heard that the risks of a c-section were higher for the mother than the baby, and that the risks of delivering him vaginally were higher for him. Was I really willing to let the weight of this risk fall on my baby rather than myself? I cried myself to sleep for a couple nights and struggled with horrible guilt. I still couldn’t imagine myself being awake while someone cut me open, so I resolved to go forward with my plans to decline the c-section and try to deliver him.

I continued to research and found Ronnie Falco’s midwife archives and learned about the Gaskin maneuver, and about how different labor positions open up your pelvis more than laying on your back. I resolved to have a natural labor at the hospital so that I could give my baby the best chance of being born safely. I explained the Gaskin maneuver, and the McRobers maneuver to my husband, and showed him some YouTube videos of both so that he’d be prepared. I made flash cards for each stage of labor so my husband could remind me of the different positions I wanted to use in each stage. We practiced the positions in our class, and talked about our plans to deal with the staff if they tried to get me to stay in bed. My flash cards explicitly said, “NO lying in bed for ANY reason during pushing” and my husband was ready to defend my wishes. We discussed the possibility that the staff might not be friendly to my requests, and we decided that we’d have my Mom join us for the birth so she could give us another layer of buffer between us and the staff. I also trusted that she’d stick up for me, like the Mama Bear she is, but that she’d be able to tell if there was a true emergency and would be able to gently help me accept a CS if it became an emergency. We continued to wait for our son to come, and were surprised when the due date came and went.

My mom arrived in town, flying in from South Dakota on my due date, with plans to stay for one full week. We were sure that Ethan would be born before she left, and so we waited. With every passing day, I endured continued comments from friends and people at church, even strangers in the grocery store – “you’re SO huge, are you sure you’re having just one?” “How can you STILL be pregnant?” “You must be so miserable!” I was losing confidence, feeling horrible, and getting scared. With each passing day I calculated that he’d be gaining around one ounce of weight – since the OBs told me he’d probably gain a half pound a week. As the weekend of my Mom’s visit came and went, I panicked at the thought of going to the hospital without her. So on Monday I met with the OB to request an induction. I was told that an induction doubled my CS risk, but I was confident that I’d be able to tough it out and have my baby as long as I could stay off my back. And I was so scared of being in the hospital without my Mom’s protective presence. The hospital was full on Tuesday, so they scheduled for me to come in for an induction Wednesday night.

Me at 39 weeks