Baby to arrive by Friday!

At 39 weeks, I went in and took the NST again. When the doctor checked for further progress, he seemed worried that there was no further dilation, and still at 50% effacement. He wanted to move the labor along right then and there and send me to the hospital. This was hard for me to take in. I wanted further discussion and explanation. Frank look dumbfounded, then shocked, then happy. I'm sure my face mirrored his expressions! The main reason for the doctor's worries (he explained to me) was because of my advanced maternal age. Statistics show that the chance of Intrauterine Fetal Death increases after 39 weeks in women age 40 and over. See my "By the way" note at the end of this post. When I told the doctor that my experience with Pitocin was "yucky" (yes, that's the only description I could come up with at the time), he said that was because it brings on the hard labor contractions, and that he could just give me an epidural. I did explain that I didn't want the epidural if it could be helped (although I won't rule it out). He said that we schedule the induction but that the day before, we try to ripen the cervix. This is done in one of two ways: using Prostaglandin gel, or a vaginal insertion of Misoprostol. They are both cervical ripening agents that contain a hormone that cause the cervix to thin out (also referred to as effacement) or even help dilate the cervix. After using one of the two methods, the baby will be monitored (using an external monitor). Pitocin may or may not have to be used next. After discussion, we all decided that Thursday I will come into the office for another Non Stress Test, then he will check to see if there is further progression. At that point, he will most likely begin the ripening of the cervix, and send me to the hospital to be monitored overnight. If nothing happens, at that point he will begin the induction with Pitocin. (Let's pray for activity overnight!) SO THIS IS HOW THERE WILL BE A BABY BY FRIDAY, OCTOBER 23, 2009! WE ARE SO EXCITED!! By the way: I found information about advanced maternal age (AMA) as an independent risk factor for Intrauterine Fetal Death (IUFD): The cumulative risk of IUFD at 38 weeks of gestation in an uncomplicated patient age 40 and over is similar to the risk of IUFD at 41 weeks in an uncomplicated patient less than age 35. These results support routine antenatal testing beginning at maternal age 40, and started at 38 weeks gestation.

38-Week Visit

Took the Non-Stress Test again. Exciting news this week is that I'm 1 cm dilated and 50% effaced. The doctor said it could happen "any minute now." I'm convinced that he's humoring me - or is he? I'm careful not to get too excited. I know there is still a couple weeks to go.

NST Success

We have had success at every "NST" visit. My advice to any mom: take someone with you, or bring something to do with you, or better yet: take a nap! Since you have to press the button to indicate movement, I was too nervous to take a nap, but the nurse kept telling me to take a nap. I think she might've been joking. Ainsley came with me twice and had fun pressing the button when the baby moved. This was fun having her with me, as she entertained me with funny stories about school. She had me rolling. I laughed so hard I was crying. This was a great way of keeping her involved. She felt really special I think. So the baby's movement in relation to its heartbeat is great which is a relief. I had to take this test because I'm old -- NO, I didn't say that! I mean because of my "advanced maternal age."

NST - starting at 36 weeks

According to my Ob/Gyn, I have to take this test at my weekly visit from week 36 to the end. This is because I am considered high risk because of my age. The test involves attaching one belt to the mother's abdomen to measure fetal heart rate and another belt to measure contractions. Movement, heart rate and "reactivity" of heart rate to movement is measured for 20-30 minutes. As I lie back and stare at the computer and machine that perform the NST test, I start to formulate questions. First, "Why am I taking this test; what are they looking for?" The answer is that they are checking to make sure that the baby's oxygen levels are normal. When oxygen levels are low, the fetus may not respond normally. Low oxygen levels can often be caused by problems with the placenta or umbilical cord. Also, "What do the results mean? Will there have to be further testing?" A reactive non-stress result indicates that blood flow (and oxygen) to the fetus is adequate. A nonreactive non-stress result requires additional testing to determine whether the result is truly due to poor oxygenation, or whether there are other reasons for fetal nonreactivity (i.e. sleep patterns, certain maternal prescription or nonprescription drugs.