Tuesday, February 28, 2012

To be Induced or not to be Induced??

This is a very long post, and it's mostly just stream of consciousness about labor and delivery. If that doesn't interest you, you probably should just skip this one :)

So.... labor. I'm ready to get it over with. I just don't know what to expect at this point, and that's a little stressful. I know you can NEVER know what to expect when it comes to labor and delivery, but the blood pressure issues have just added another element.

I didn't have a firm "birth plan" before blood pressure issues and bed rest, but I did plan to be flexible and just go with the flow. When I was in labor with Jude, it went really quickly. I was 9 centimeters when I got to the hospital, and that was not because I intentionally tried to labor at home. It was just that fast. I was so convinced that I wanted an epidural and I was so mentally unprepared for a natural childbirth, that I totally panicked when they told me I was 9 centimeters. I begged for an epidural and ended up getting one at almost fully dilated, even though I knew there was a good chance it wouldn't do much at that point. I did NOT want to feel the baby come out, and the anxiety I felt over the possibility that I might was off the charts. Well, guess what? I felt him come out anyway. And it was every bit as painful as I feared it would be. But I lived. And when it was over, I actually thought to myself, "I should have just done that without an epidural after all." Part of the reason I thought that was pride. I mean, I feel like I pretty much gave birth naturally, but I can't even say I did it. Ha! I quickly got over that, though. I was healthy, my baby was healthy, and so it was a beautiful, wonderful birth experience, and I have no regrets looking back.

However, I did tell myself that when it came time to give birth to baby #3, I would be more open-minded. If my third labor was similar to Jude's and things were progressing quickly and smoothly, I wouldn't get the epidural. It just didn't seem necessary. (Plus, it would save us a LOT of money because of insurance reasons.) On the flip side, if my labor was completely different, slow, or with complications, I would be open to getting an epidural with no regrets. Honestly, as amazing as I think it would be to give birth naturally, it's just not something that I'm passionate about. I have friends who ARE passionate about it, and I support them and cheer them on 100%. I like to think they do the same for me whether I have an epidural or not. All that to say, I was going to be open-minded this time, and not set myself up to feel like a failure if I got an epidural and not feel like I was going to die if I didn't. One thing I was sure of, though, was that I didn't want to be induced. (And I'm not even talking about if I was way over due or a situation like that.) Again, I'm not saying inductions don't have a place. That's not for me to decide, and it would be hypocritical for me to say that because I've scheduled inductions both times in the past and then gone into labor on my own before the induction date. So for me this time, I just thought it would be better to go into labor on my own again when the baby was ready. My body has done it twice before on it's own (before my due date even) and it has worked out really well, and I've had great labor experiences both times. So, I wanted to continue with that pattern.

Then enter bed rest and high blood pressure. When I was first sent to the hospital for my blood pressure, it was a very real possibility that I would be having the baby at 37 weeks if I had preeclampsia. I would never refuse an induction under those circumstances. I know preeclampsia is very dangerous, and I would want the baby out as soon as possible for the safety of both of us. Thankfully, I didn't have preeclampsia. I was diagnosed with gestational hypertension and sent home on bed rest. I'm also thankful that my high blood pressure seems to be easily controlled with lots of rest and non-activity, so I didn't even need to go on any medication. So, that's where we are now. Being on the couch all day has given me lots of time to think about my labor and how I envision it all playing out now. I actually had a lot of anxiety over the possibility of going into labor at home, being really progressed and in a lot of pain by the time we got to the hospital, not having time for the epidural, and my blood pressure being off the charts due to the extreme pain of a natural birth. I started to wonder if an induction would be the safest option for me under these circumstances so that my blood pressure could be monitored the whole labor.

I got to talk to my doctor about my concerns yesterday. She was really great and gave me honest answers (my doctor is very blunt and honest - haha). She basically told me not to worry about that. My blood pressure isn't high enough for that to really be a concern apparently. She said women's blood pressure naturally goes up during labor without pain medication, and she doesn't expect mine to go much past what anyone's would. Well, that's good to know! It did make me feel a lot better, and while I am still a little nervous about the possibility, I'm just going to trust what my doctor said and, most importantly, I'm going to trust God to take care of me and my baby.

But then we talked about induction. My doctor said that she really recommends that I agree to be induced at 39 weeks. She said that's about as far as she feels comfortable pushing it. The baby's lungs should definitely be mature by then, and she said she could break my water. I may or may not need pitocin. She did say that if I REALLY wanted to avoid being induced, we could "negotiate" assuming everything looks ok at my next appointment in a week. So, the question is, do I want to negotiate? Here's the weird thing: I would never judge another woman for being induced because of high blood pressure. To me, that is a valid, medical reason to be induced. But I'm just terrified that if I'm induced early, I'm going to seem like one of those women who is just "done" being pregnant and has no real reason to be induced. I mean, what is really best for my baby? Is it better to avoid the risk that the gestational hypertension could turn into preeclampsia and just be thankful that we made it 39 weeks and go for the induction? Because clearly, it would be better for both the baby and myself to avoid preeclampsia. Or would it be better to ask my doctor for a few more days and give Alaina the chance to come when she's ready? I really feel like she'll come on her own before my due date anyway. (Just because both of my other babies did... I know that doesn't necessarily mean anything, though.)

I also feel torn because I have to think about not only what is best for Alaina, but what is best for my entire family. I know bed rest is hard on everyone, and it will be so much better when I can start being a mom and taking care of household things myself again. We appreciate our families and their help so much, but they all have lives too, and I would like to be able to go a day without needing constant help. Plus, I think it's just hard for Aubrey and Jude to have me on the couch all the time. It would be best for them for our life to return to normal. Well, as normal as it will be with a newborn! ;) So, in that sense, having the baby as soon as possible seems like the best option.

Right now, I'm just thinking about my options and praying that the Lord will give me wisdom to make the best decision. This is not something I'm taking lightly, and I want to be at peace with whatever decision I make. Of course, it all depends on what my doctor says next week, too. If my blood pressure is worse, or if she STRONGLY recommends the induction, I'll do it. I completely trust my doctor, and I don't feel like she's trying to force me into an induction just because she's ready to check me off her list or anything. I think she will be honest about what she thinks is best. If anyone has any insight or words of wisdom, please share. I go back to the doctor next Wednesday and the date she mentioned for an induction is next Friday. Ideally, I will just go into labor on my own before that, and the decision is made! :)

Whew, if you read such a long winded post, thanks! Didn't mean for it to get so long!


Whitney said...

I'm just going to ramble, probably not to help at all, but so you know you aren't alone! First I want to say that in all of these decisions, there is no good vs. best choice. Whatever choices you make will undoubtedly be with you and your family in mind, so it will be the BEST.

As far as induction, it's no secret that I will likely have one. I think it will be happening very soon, and I could possibly have to deliver somewhere with a NICU just in case Sam's lungs aren't mature. Thankfully we're both just fine now, and the goal is to deliver while everything is fine instead of continuing to push our luck. You and I both would like for things to be different, but this is what has been handed to us, and we have to do the best we can. Like you, I'm ready for life to get back to "normal," but neither of us are choosing induction just for that. Bed rest has caused my family to make several decisions, knowing that we're choosing what's best for all of us.

If you're worried about pitocin, I had it last time because of BP and had no trouble. I also had an epidural that didn't take quite well, but it did help with my BP!

I'm thinking of you while you make these decisions and also while you wait for Alaina. With your doctor and family, you will certainly make the best decisions for all invovled. A healthy baby is all we want!

Mary Louis Quinn said...

Ok, here's my two cents for what it's worth (coming from a stranger) :)- If all things check out OK at 39 weeks (BP, etc), I would base the induction on whether or not your body seems ready, i.e. have you progressed at all? The chances of laboring for a long time and/or having to have a section increase with induction if you have no progression. But if you have already started dilating and effacing at 39 weeks, then chances are an induction would go really well for you. So if your BP checks out ok, you haven't progressed any, and you still feel strongly about waiting for labor to come on it's own, I would think about asking her to hold off on the induction. But really an induction at 39 weeks would probably go pretty smoothly, especially since this is your 3rd baby, and I would try not to feel guilty for any decision you are making or feel like you are "rushing" things. Clearly you (and your dr) have put a lot of thought into this, so hopefully you will feel comfortable with whatever decision you make!

Sarah Denley said...

First of all, as one you "cheered on" so faithfully, know I will do the same for you regardless of whatever you choose! I don't think anyone will think you're just one of those women who are "done" being pregnant!

I think ML offered some great advice and I think it's really important to listen to what Dr. Missy says. We know she's got her head on straight and like you said, with her it's not an "agenda". At the same time, I think if she's leaving it up to (i.e. negotiating), she must be somewhat comfortable with it. That woman will tell you firmly if it's something she feels strongly about. Ha!

And I think it's great you're balancing the needs of your other children. Like I've talked about SO many times, the best decision we make is the one we make with consideration of our whole families!

I love you and you'll do great no matter what happens!

Kristal said...

I hate you are in a tough position, Carrie. Just know that whatever you choose, you will be supported and we will know that your did what was best for you, your family, and Alaina. Don't let others' judgements make the decision for you.

And I will be praying that you go into labor soon and this will all be a moot point. :)

Ashley said...

Ahhhh, I know this is such a hard thought process for you. I can picture myself being the exact same way if I were in your position. It's like me desiring a VBAC but feeling trapped. These types of decisions are hard!

Your body seems to do labor and delivery so easily, and I really have a feeling Alaina will come on her own before you're having to make induction decisions. I would schedule one because that gives you a "light at the end of the tunnel." If you change your mind, no biggie.

I can't wait to meet Alaina!!! And you KNOW that I love and support you regardless of your decisions!