Decisions to make!

Well, I love my regular OB.  I should have known that the crazy doctors over at Maternal Fetal would not influence her opinion or our plan.  Thank goodness for doctors that are on the same page as you are!  I feel much better after talking with her yesterday.  I was chatting with the front desk girl yesterday before my appointment and she mentioned to me that Maternal Fetal Medicine does tend to try to make things difficult...they have quite the reputation!  That made me feel a bit better about the whole situation.

So, first the updates:  my pre-eclampsia test came back negative, and my blood pressure the past two days has been back down under 120/80 like normal.  Apparently I do have a *slightly* high creatinine level.  This is a measure of kidney function, and normally they want the level between .06-1.2, and mine is .08.  However, they want it a bit lower in pregnancy, more like .04-.06, so in that regard it is a little high.  Doc said this is most likely just because of the diabetes, nothing to worry about.  All my other results were stellar and she couldn't be happier with how the pregnancy is going.  Finally...a positive doctor!

Then we talked about Maternal Fetal...they sent over a letter to my doctor stating there was no reason to schedule any induction/c-section prior to the end of 39 weeks.  The baby is large, but because head & stomach are the same size (both greater than 90th percentile), her size is not due to the diabetes, she is just a big one!  The high risk doc said I have good control of the diabetes, Ava is healthy & happy, and therefore there is no reason to plan anything.  My OB was very happy with the update.

I mentioned that I was a bit concerned about the whole "no need to schedule" idea seeing as how Ava was already 7.5 lbs at 35 weeks and I have another 4 weeks to go (5 if we go to 40 weeks)...which by my math calculations is a 10.5-11.5 baby.  I don't want to push that baby out!  My doc explained the high risk doc was saying I could "try" because Ava's head was the same size as her belly...so if the head gets out, then so does the rest of her.  If her belly was much bigger than her head (like many diabetic babies), then there is a very high chance she will get stuck in the birth canal - that would be bad.

She also said that most women who try to deliver a 10+ lb baby are doing so because they want to try, not because the docs are comfortable with it.  She said she has been more nervous during delivery than the Mom was due to the size of the baby.  She has seen women be successful, and she has seen women stall out or have the baby go into distress and have an emergency c-section.  However, she said that the ultrasound estimates are not exact, and Ava could be smaller (or larger) than they think she is.  She wanted me to make sure I understood it was my choice if I want to try having a normal delivery or if I want to schedule a c-section.  Worst that happens is I try a normal delivery and I stall out and have to c-section anyway (my worst nightmare).  She also said I could wait until after my 38 week growth ultrasound to make a decision if I want to.

I decided to take another week to think about it and talk it over with Johnny to decide what I am going to do.  I just have a gut feeling that even if I try a normal delivery, it will end in c-section (due to her size & the complications from diabetes).  I don't want to c-section (mostly due to the recovery), but I also REALLY don't want to push out a baby.  Again, I wish the stork were a delivery option!  There are many who feel the birthing of a child is a wonderful experience that they would feel incomplete without.  I feel it is a necessary evil to end up with a my little one in my arms :)  So the "birth experience" is not important to me...what is important to me is to have a healthy baby in my arms at the end.  I think at this point I am leaning towards a scheduled c-section, and if something happens (like at the next ultrasound they think she is only 7 pounds or if I go into labor early), then so be it.

The doc also explained they cannot schedule an induction before 39 weeks without doing an amniocentisis to make sure the baby has fully developed lungs - so that option is pretty much out as long as Ava is doing well inside my belly.

I am currently not progressing at all.  My cervix is still closed, long, and baby hasn't dropped.  Granted, that can change quickly so it is still possible she will come naturally & early, but I've been told the chances are pretty slim (although I'm hoping, but only if she is ready to come out on her own!).   I hit 39 weeks on 2/5...so sometime between 2/5 & 2/12, I expect Ms. Ava to make her arrival!  It's probably good if I end up making it to 39 weeks because I will have a week off before she arrives to get all the last minute things done around the house.

But I'd better start doing some wall push-ups to make sure I can lift her!  :)

Well, not quite a 19 pounder...

But still a BIG girl!  Today, at 35 weeks 3 days, our "little one" is 7 pounds 8 ounces!  That is the size of a FULL TERM BABY!  She still has 2.5 weeks until she is considered full term...goodness gracious.  And even then, she has another 5 weeks until due date.  Between the last ultrasound and the one today (1 month) she put on 3 lbs...so logic would say she will probably put on at least another 3 pounds in the next 4 weeks...which puts her at 10.5 pounds!  GOOD LORD.  I am already having nightmares.

I expected her to be big...they have told me from the beginning they expected her to be 9-11 pounds, so she is right where they thought she would be.  My problem today is that the high risk doctor basically told me that we will do another ultrasound in 3 weeks to determine what we should do.  But my regular OB told me two weeks ago that we would be scheduling my induction/c-section date TOMORROW.  When I mentioned to the high-risk doc that I was supposed to be schedule tomorrow, she said she saw no reason to schedule at this point and that if the baby hasn't come on it's own by 39 weeks, then we'd schedule.  She also said she was going to be sure to call my regular doctor and tell her not to schedule me.

What the heck?  I have only seen this high risk doctor one previous time...I have been seeing my regular OB for 20 weeks!  Why does she have to meddle in my business????  I WANT A DATE!  I know most women don't have one, yada yada yada...to that I say, most women haven't been going to the doctor every other week for their entire pregnancy, haven't been having 3 appointments a week for the past 6 weeks, aren't now going to 5 appointments a week for the next 3-4 weeks...I DESERVE TO KNOW THE DATE GOSH DARN IT!!!

Not to mention, I have been told since day 1 that I will be induced/c-sectioned - I will not be allowed to go to "term" (40 weeks) because of both the size of the baby as well as placental deterioration (common in diabetics). 

My regular OB has told me she believes me capable of delivering of 9 or maybe a 9.5 lb baby, that I was just built for that kind of size, but she would question whether a 10+ lb baby would be possible.  Now, I trust my doctor 100% (and am not interested in hearing anyone's opinion on why I should not), and she has been doing this for a LONG time.  If she questions my ability to push a 10+ pound baby out of me, then I question my ability.  And I have NO DESIRE to prove her wrong!  Now, if the baby was going to be 7 lbs, than yes, please let me deliver normally.  But 10+?  That is a different story completely.

The high risk doctor tells me I can "try" to have Ms. Ava.  The thing is, I have NO DESIRE to TRY to push a 10+ pound baby out.  None!  And I don't want to "try" and end up having to c-section in the end.  Now, I know that something could happen even with a smaller baby and I could end up having to c-section.  And while I personally believe that would really really REALLY suck, it could happen.  But I don't see the point in setting myself up for failure and for the worst of both worlds.  If the odds are stacked against it, why would I do it?

I thought tomorrow would be the day I would finally know which way and when Ms. Ava would make her grand appearance.  Now it seems that this high risk doctor is going to call the shots, and I am not terribly happy with that.  I hope my regular OB isn't railroaded by her...Even Johnny thought the high risk lady was a bit...high & mighty and a know it all.  So I know it isn't just my opinion.

I wish I could make my head work straight...I just feel so crazy right now in so many ways...sometimes I feel like I just cannot handle all these doctor appointments and all this worry anymore.  I think it is extremely hard for people to understand or relate because even if they have been pregnant & miserable, they have never had to go through the level of scrutiny that I am still going through.  It is mentally, physically and emotionally exhausting.

Here is to still hoping I will know tomorrow when I can finally meet Ms. Ava and leave all these doctors in the dust!