I am really looking forward to the day when I can stop posting midwife updates and start posting actual BABY updates

Today's update is that I am now 3 cm, my membranes have been stripped and New Baby had another NST that showed she's doing just fine. She also flipped around last night (and believe me, I FELT IT HAPPEN) and she's now backwards or "sunny side up." Not SUCH a big deal but labor will likely be more painful and longer this way. It would be best if she reversed herself.

Finally, my midwife broached the topic of induction and asked if I wanted to put a date out there and I declined, saying that I'd rather wait until Monday to discuss it more then. She thought that was fine but did say that we're getting to a point where she begins to worry about meconium and aspiration but we'll discuss more on Monday if nothing happens in the next few days.

I mean, 3 cm? 41 weeks? Membranes stripped? Sporadic contractions? This is going to end soon, right? All signs point to yes? SOMEONE PLEASE SAY YES.

***

It's typical risk management at this stage of pregnancy for a care provider to ask questions about meconium and meconium aspiration and meconium aspiration syndrome. It's a possibility that we need to be aware of so that we can weigh it versus other distress factors present (of which there are currently none except for the part where I am 41 weeks pregnant). I see four possible ways to begin to end this pregnancy at this point:

1. Go into labor on my own; no meconium

2. Go into labor on my own; meconium

3. Induction with no meconium

4. Induction with meconium

She's worried about meconium simply because of the dates, which I agree is an actual risk. She didn't push me or pressure me, it was more of a truly open-ended question that she wanted to get my thoughts on. Am I ready to be induced? Because there is this thing out there that might happen, so it would be a valid reason. Or not? (NOT! NOT! NOT!) I sort of got the feeling that she was gently offering me an out, especially since I told her that I woke up today and just felt DONE.

I am not sure that the smallish risk of meconium being present (because of course, it might not be present at all)  is enough to warrant induction, particularly with a backwards baby. I'm initially inclined to give New Baby a little more time to flip back the way she's supposed to be.  That is, if I was induced because we were frightened of meconium and there was no meconium? I would be relieved but I would also be kind of pissed that I'd just put myself through that (with a backwards baby that might be tougher to get out in the first place, which has risks of to New Baby but which might lead us more towards an eventual c-section), especially with an active baby showing no signs of distress and continuing to perform hourly acrobatics with healthy levels of amniotic fluid.

So, long way to say that we'll talk about the risks of meconium on Monday and I'll be doing a lot of research in the meantime and we'll make a decision then. But, I think I'll be hard pressed to agree that the MAYBE, UNKNOWN risks outweigh the DEFINITELY PRESENT risks of induction (and oh, there are SO MANY) plus the fact that meconium could be present in either scenario (it can be present at 37 weeks or 42 so it's kind of a crapshoot).

Induction early next week seems to give us the baby sooner, but not necessarily healthier or with my uterus intact and not sliced open.

So, yeah. I knew this question was going to present itself (because I'm just not lucky enough to go into labor at a reasonable time like a normal person) and I'm not very happy about it. Best case scenario is that I have this baby on my own before I have to deal with this rabbit hole of information and statistics I'll need to understand first to make an informed decision.

Comments

[Life of a Doctor's Wife]

I wish I had something awesome to say here, but having never gone through this before, I will just say, hang in there! And hope that New Baby flips around and decides to make an appearance soon.

[Manda]

If you want a perspective on meconium let me know. Syd didn't aspirate but it was present (however I have had two IRL friends who have dealt w mec aspiration). My point: I have some experience with it with both outcomes.
This baby is going to get born! You're doing great. This right here is the absolute worst part... The waiting!

[Holly]

We had meconium at Clara's birth (only 4 days overdue, no induction, face down, no drugs) and they aspirated her lungs out (or something, I was kinda busy going A GIRL A GIRL A GIRL?!?!?!) and everything twas fine. I think they watched her a little more closely, but nothing weird.

[Erica]

Hang in there, you are doing great!

[Sarah in Ottawa]

We had mec with Veronica, and with the shoulder dystocia there were a few crappy minutes where the midwives didn't want to encourage breathing b/c of the mec and because SHE WAS STUCK which lead to intubation and chest compressions after an APGAR of 3. But within minutes, she was fine and has suffered no ill effects.

Baby before Monday. New chant at your house!

[Erin G]

I had meconium issues with both of mine -- Nathan (4 days late) had to have his stomach pumped, and even then it wasn't enough for me to want to be induced with Anneliese (6 days late) who also ended up with meconium, but didn't inhale or swallow it so they did very little for her besides clear her airway when she came out to prevent the inhalation.

Both of them are fine.

I know that not all babies are, but I'm not sure I'd go for an induction if that's the ONLY reason/risk I'm weighing. Actually, I'm sure: I wouldn't. Maybe at 42 weeks, but def not at 41.

(Have I mentioned I hate pitocin?)

Worth having the conversation, though.

Hang in there! 3cm + membranes stripped = BABY SOON!! :)

[Elizabeth]

Yep, I had meconium with Katie Dubs and it wasn't a big deal at all. Basically the only down side was that 1. they made a big deal out of it and kind of freaked me out and 2. they didn't put her right on my stomach after she came out, instead they took her away and sucked some gunk out for a few minutes and then brought her back all wrapped up.

[Sheila]

I'm with Elizabeth, except I was so exhausted that I wasn't capable of freaking out. My husband freaked out for me-- especially when they took him, wrapped him up, and then didn't let me hold him for another FIVE HOURS because of meconium suctioning, bathing, shift changes, etc. I think he was frustrated that I wasn't more angry but... I was just too out of it to even realize what was going on.

I got mad about it later. Of course.

[HereWeGoAJen]

I scheduled an induction when I reached 42 weeks because I was concerned about the increased risk of stillbirth when you go too far past that. I did have some problems during labor with Elizabeth's heart rate because she was getting so overdue (and I went into labor on my own two days before my scheduled induction) and I had to be on oxygen for the rest of my labor. Overall it was just fine. And there was no meconium.

[Emily]

I have no experience with anything except emergency c-sections. They're a BLAST.

But I do want to say, that no matter what you decide, there could always be a different outcome. Hindsight is always going to be 20/20. So go with your gut. If you induce and there's no meconium, well, how could you ever have known? That kind of thing is never going to be predictable, and you can't let it upset you. You can't be expected to do this thing absolutely perfectly. I think you've got a provider who is being exactly what you need, and I think she really does have your best interests in mind. So you're doing great, and you have a really exciting weekend ahead of you reading about... baby poop.

XOXO

[Karen]

My last two babies were sunnyside up; during my labor with the last one, my doula had me get on my knees and lean against the birth ball while she rubbed my lower back--really hard, but it felt good--and he flipped to the "proper" position, making labor so much easier.

There is a website called "spinningbabies" or something like that, with exercises designed to help babies move into the right position. Good luck!

[Robyn]

As a doula, I second the hands and knees or birth ball and knees at suggested above as well as visiting the spinningbabies website.

I've also have a posterior labor (with my over 41-weeker) - it sucks! Try and get that little one turned if you can. Be sure hubby gives lots of low back counterpressure over your sacrum during the contractions if you're having lots of back pain.

Hope you're laboring soon!

[Carmen]

I had a 42 week postdates induction with a sunny side up baby. It was no worse than my first three babies - interestingly enough, my fifth was not induced but was also sunny side up - she flipped as she was descending, oh so ouch - and that birth was my most intense.

I second - third, whatever - the hands and knees. I had my bare ass in the air the last two hours and it helped SO much.

[hydrogeek]

De-lurking to say that you just can't ever tell about the meconium. My first labor was at 41 weeks, it was 30 hours long, and I had to have pitocin for the last 10-12 hours even though I wasn't induced, and my girl had meconium. My second labor was at 42 weeks, not induced, 20 hour labor, and no meconium. For what it's worth, even my first baby with meconium did just fine. They actually suctioned her really well when just her head was born, then once she was all the way born, they whisked her over to the isolette right next to me and "deep suctioned" her (whatever that it, I'm afraid I don't want to know) and got her right back to me. If I remember correctly, they told me they didn't think she'd aspirated any meconium, but they did all the suctioning just in case. Good luck, and I'm thinking labor-y thoughts for you!

[Elsha]

Thick meconium and super-low heart rate was what led to an emergency c-section with Kalena. She had aspirated it and as a result had two collapsed lungs. She spent like 30 hours on oxygen and was fine in the end.

Here's the thing though: I had actually been to the hospital earlier that day (false labor) and all monitoring had indicated that she was fine. But the doctor told me later that he believed that there had been meconium present for several days because it was so thick for one thing (all my amniotic fluid was meconium sludge) and because her fingernails and toenails were stained with it-- it took several days before the staining washed off. And they couldn't tell me anything about the placenta because it was also meconium stained.

I'm glad I went into labor on my own though, because otherwise I always would have wondered if being induced was was caused the distress. I hope your baby gets the memo that now is the time to arrive!

[Margaret]

The end of pregnancy is so, so hard. Praying for you & for the baby to come soon!

[Jessica]

Baby girl, it's not funny anymore. COME OUT.