Today I had my 36-week appointment. 8 months down. 1 month to go.
Everything was pretty routine. I've gained a pound in the last week, bringing my total gain to something like 28 pounds. (Respectable.) My blood pressure was normal. Baby's heartbeat is lovely at 138 bpm.
She checked baby's position (head down, excellent) and then took a guess as to her size. She jostled my belly this way and that and made a face like she was concentrating.
"Well. This is a pretty good size baby! I would guess about seven or seven and a half pounds already!"
Now, keep in mind that this is nothing more than an educated guess. She scheduled me for an ultrasound next week to "try and get a better estimate of size." Both numbers are subject to a wide margin of error. At this point she should be growing by a half pound per week, so we're looking at possibly a 9.5 pound baby if we want to get really crazy with the numbers.
However, the internet is positively littered with stories of "My doctor told me my baby would be huge and she was just six pounds!"
Her next statement set off alarm bells. She mentioned that if the baby keeps getting big we may want to look at an induction in the next two weeks because if she really is as big as they think it puts me at a higher risk of emergency c-section.
I produced a vague smile and said something like, "Uh-huh. We'll talk about it later...."
I will not be cowed into an induction to avoid the vague possibility/threat of a c-section that may or may not turn out to be necessary because my baby may or may not be "too big."
The trade just isn't worth it. Inductions double a first-time mother’s risk of having a caesarean section. (Which begs the question, what's the risk of a caesarean if you think she's too big versus the induction itself?)
And inductions are bad, bad, bad. Yes, for some women who are post-date or have other complications the benefit of an induction certainly outweighs the risk. I am open to being convinced otherwise, but I just don't think "the baby might be big" is a good reason to induce in my case.
Inductions are famous for producing more intense and longer contractions. This can result in reduced blood flow and oxygen to the baby, requiring constant monitoring. Continuous fetal monitoring has been associated with greater likelihood of c-section.
More intense contractions lead to the more necessary use of pain medication. Risks associated with pain meds commonly include slowed labor or poorly progressing labor - both reasons to perform a c-section if it's deemed the mother isn't making significant progress fast enough for everyone.
Of course, I have clear sight of the objective - safe mother and safe baby. But I don't want to go through hell to get there. I don't want to be induced and I don't want an epidural.
Oh wait - are you surprised that I don't want an epidural? Sure, it cuts the pain - for now. The truth is that if I end up with a caesarean I'm looking at WEEKS of pain in recovery from major abdominal surgery rather than the alternative of just a few hours.
(And, don't forget that the c-section rate in this country is astronomically high - more than 29%! Just BEING in America makes it a real possibility for me.)
There are other complications caused by a large baby and those can be Very Bad and Scary too. However, just guessing that "this baby is big" and using that as a reason for induction isn't an equitable trade of risk in my book.
Call me crazy, but I have no doubts about my ability to successfully deliver a large baby. After all, I weighed about 8 pounds and my brother was nearly 10. My mom and I are of similar size and shape - I tend to think that if she can do it then I can.
Mother Nature is pretty darn smart. True Cephalopelvic Disproportion (the official term for "your baby is too big to fit through your pelvis") is rare.
The thing is, I really do believe that one intervention leads to another and that once you start on that path it's difficult to get off. I do think that some medical professionals are motivated by finance. (Cesaerean births do cost more.) I also think that some doctors practice defensive medicine. That is, they make medical decisions based on the possibility of litigation.
And, I absolutely think that some physicians and the people they surround themselves with make decisions based on their convenience.
This is really the crux of the matter for me: I am not interested in being convenient...for anyone. I tend to see "maybe a big baby = induction" as an excuse for my doctor to deliver the baby on her schedule.
We'll see what happens at next week's appointment and take this whole thing day by day.
Why must this be so complicated?
The upside? We get to see the baby again next week! Wa-hoo!