Another sonogram and looming deadline

My due date is Saturday. And it is as accurate as you can get, because I knew the day I ovulated (July 8th). That date matched up perfectly with the 9 week sonogram. So there is no avoiding the actual 40 week mark (although I read that white females with private insurance...i.e. healthy and well-educated pregenancies, tend to have a gestation period 10 days longer than the 40 week average of other ethnicities or socio-economic groups).

I had another ultrasound this morning to re-measure my fluid index. As I posted earlier, It was 27 at Christmas, 34 in February, 32 last week, and today it was 30. I had thought the top of the normal range was 25, but Jessica the ultrasound tech said normal actually topped out at 20, and medical professionals start to look worried when it goes over 25. Either way, I'm not sure I'll hit a low enough number by next week to make everybody happy. But I am going down. That's a good thing.

The babies biophysical profile was 8 for 8 again today, including a nice long session of practice breathing and all the body parts with the appropriate amount of movement. She was so active in fact that Jessica had a hard time capturing the heart beat and blood flow through the cord. When she finally caught the heartbeat, she seemed to see a dip in the rate, so she called Susan the midwife and confirmed that an NST (non-stress test) would be a good idea, just to make sure. I personally think any heart rate problems with the sonogram were a result from me laying on my back (the bed-angler was broken) and the overactive baby that wouldn't let her get a good solid reading.

A non-stress test is basically ten minutes or more on the fetal monitor in the observation wing of labor and delivery. So I drove to Baylor Medical Center, signed in, firmly told them I was laying on my left side for the reading (they said it didn't matter either way), and waited for a long enough test strip to show up that Susan could review. I was there for about an hour, which was fine because my results were spectacular, including some small contractions with perfect response from the baby's heart (the medical professionals are very reassured when the baby responds well to contractions...they use that as a forecast for how the baby will handle the rigors of labor).

Susan actually came down to labor and delivery to see me, which was nice because I wanted to talk to her about the fluid levels and what would happen next. She was very happy with the readout and said I was free to go. She said that 30 was still high, and that they would still want to induce me, probably early next week; and that would be decided sometime between tomorrow and my visit with an OB from her office on Thursday (routine procedure for all midwife clients to see an OB from the practice at least once). I told her Lindsay had been talking about starting off the induction with artificial membrane rupture, which I had read in What to Expect When YOu're Expecting and several other books was a big no-no with high fluid levels...it increases your risk of cord prolapse just as much as if you were to spontaneously break your waters, which is what the induction was supposed to circumvent. Susan replied that they wouldn't use the usual crochet hook and rip a hole in the sac, but rather a small pin-prick for a slow leak that would let the head settle slowly onto the cervix (which I had read was a viable alternative in my situation). Going into labor with strong contractions is still preferred, so we are still working on natural induction methods to get me going this week.

I know that ruptured membranes is the point of no return as far as induction goes, so I asked her what would happen if I didn't go into labor with this step. Susan said that 18 hours after membrane rupture, they would give me antibiotics as a precaution, and would let me go as far as 24 hours before they needed to see signs of active labor. This is a big improvement over many OB's, some of whom do a c-section as soon as 12 hours later, and most will do a c-section after 24, no matter how far along you are. Susan also said the second course of action would be cytotec 25 micrograms (vaginally inserted cervical softener), which I still want to research. Cytotec is FDA approved for ulcers, not induction, and tends to be so strong that the side effects in some cases are really horrible, including a few cases of maternal death. I think Susan referred to it as the rocket fuel of birthing babies or something like that. I know there are other cervical softeners out there, and want to read up more on them so if it gets to that point (hopefully it won't) then I could have a substitute request. Susan said pitocin was not a good choice for secondary induction methods, and I tend to agree. It makes contractions harder for both me and the baby, puts me in the bed with the monitor (to watch for the very likely fetal distress), gets an IV in me, and all sorts of other interventions that go down a road I want to avoid at all costs. Susan told me drinking rasberry leaf tea and evening primrose vaginal suppositories would be good to add to our list of attempts.

Susan did a cervical check on me and said my cervix was very soft (so soft it was hard for her to pin down), posterior, 50 or 60% effaced, and just about 3 cm. A soft cervix is good because that means it stretches easily with pressure from a baby head. Posterior is bad, but might be a temporary thing just because the baby is not at a lower station (susan said she was high, but didn't give me a number). 50 or 60% effaced is the same as last time, but 3 cm is definitely an improvement. It means I am officially done with early labor, lol. I passed my mucous plug today, which doesn't mean much, except that I am still dilating and opening up. My books say a mucous plug comes hours or sometimes weeks before labor.

Susan didn't know how to figure my Bishop's score from her new findings (which surprised me), but said it might not be relevant in my case because of the babies failure to drop consistently. I don't know if I believe that or not, but I am reassured that I got another cm and considerable softness to add to my score. My guess is it brings me up to a 6 or so. I would still like to be at least a 9 before they do anything permanent like break my water.

In other news, Hailey has a virus. It is not influenza, because Michael took her to the pediatrician and had her tested, but it does come with a really high fever (104.3 at one point, and around 102 with tylenol and ibprofen). The Pediatrician said to limit her exposure to me, which means I haven't touched her since this morning; Michael has been medicating her, holding her, etc. It's a good thing he is working from home this week, but also awkward at points when he needs to actually hunker down and get seriously focused on an assignment...This afternoon I just watched Hailey from a distance, ready to call Michael if physical contact was needed at any point to help Hailey. I've purelled myself like three dozen times today, and bought another container of clorox wipes. I washed all our sheets, because Hailey has visited our bed recently in the morning. Michael aired out the house by opening lots of windows, even though it was raining outside. It would be very bad if I had a virus with a high fever and went into labor.