Another midwife visit.

[rivka]

I can't believe that I'm still pregnant after 10 days of prelabor.

Yesterday the cramping and the sharp pains around my cervix were so uncomfortable that they almost had me crying. Today I'm feeling a bit better, physically - well enough that I took a walk around the block - but I'm very discouraged.

At today's visit I was 3.5cm dilated and 60% effaced - barely changed from a week ago. She stripped the membranes, with my permission. It really didn't hurt any more than a regular pelvic exam. Hopefully that will do something, but I'm not feeling especially optimistic right now.

We talked about things I could do to speed labor along. My midwives really don't recommend castor oil, but she did suggest that I start black & blue cohosh - 10-15 drops each in a little water, every 30 minutes until contractions are regular (or for four hours, if contractions don't start). I'll try that in the morning. I'm also going to continue with the evening primrose oil. She recommended sex, spicy food, nipple stimulation, crying, and yelling at curiousangel. (I'm pretty sure the last two were jokes.)

At 41 weeks - so, this weekend - they want me to go in for a nonstress test. She told me to bring my suitcase, because if the baby's in distress I won't be going home again, but also said that there's no reason to believe that the baby will be in trouble. Because of the situation with my hip, after 41 weeks they're willing to go any direction I want to go - waiting, or induction, or scheduling a C-section. If I wait, they'll do a biophysical profile between 41 and 42 weeks, and then after 42 weeks they would want to see me three times a week to monitor the baby's condition.

We talked the most about a Cervidil induction. She said that even though it's primarily a cervical ripening agent, when the cervix is already ripe it usually brings on contractions. (She said it works that way for about 75% of the women in their practice.) The big advantage of Cervidil would be that it could be removed if the contractions got strong, and that it wouldn't necessarily lead to the cascade of interventions you can get with a Pitocin induction. I would have to stay in bed and not eat anything for the first two hours, but after that I could move around, get in the tub, go home if it doesn't work, etc. I wouldn't need an IV or continuous fetal monitoring.

I don't think we're willing to try a Pitocin induction unless the baby is in distress. It just seems like there are too many downsides.

A friend recommended that, if I turn out to need a Pitocin induction, I consider just scheduling a C-section instead. She pointed out that the only thing worse than a C-section is a long hard labor ending with a C-section, and that I've already been told I have a greater than 50% risk of section anyway. I am not convinced, but I'm sitting with the idea to kind of get used to it.

I'm having some cramping now from the internal exam. I wish that at this point I believed that cramping *meant* anything.

Comments

[timill]

Sisyphus? Or Damocles?