Well, here we are, January 17, 2008. D day. And still absolutely no indication that the baby will be coming any time soon. I had a check up yesterday with my doctor, pretty uneventful, as I expected... All looks well with the baby, which is a good thing, but it's frustrating because I am still barely dilated, and I really haven't had much in the way of contractions (aside from Sunday when I was at the movies). He hooked me up to the monitor, and had the same problem as the other day when I went to the hospital for the back pain - the baby wouldn't stay on the monitor well, but they were able to do the non stress test just fine. He checked my cervix again, which is still pretty much exactly the same as it was the other day, which means it's not changing at all. So after I changed, he came back in, and told me he wants me to come in on Monday for another NST, then talk with Dr. MacVittie about induction. He said there is no benefit to waiting until you hit 42 weeks to induce, the risks are all the same either way - at 41 or 42 weeks. So, unless I go into labor naturally between now and Monday, I have an 8am appointment. And it looks like unless I go into labor naturally by the end of next week, I'll be getting induced at some point.
So, since the website I had been taking all of my information from doesn't have much for people that go past their due date, this information is being taken from the 5th edition of
Your Pregnancy Week by Week.
Your due date has come and gone. You haven't delivered yet, and you're getting tired of being pregnant. You are anxious to get labor and delivery over and finally meet your baby.
You keep seeing the doctor, and he or she tells you, "I'm sure it'll be soon. Just sit tight." You feel ready to scream. But hang in there. It
will be over soon - the wait just seems never-ending right now.
What Happens When You're Overdue?You've been anticipating the delivery of your baby. You counted the days to your due date - but that day has come and gone. And still no baby! As we've mentioned, not every woman delivers by her due date. Nearly 10% of all babies are born more than 2 weeks late.
A pregnancy is considered to be overdue (
postterm) only when it exceeds 42 weeks or 294 days from the first day of the last menstrual period. (A baby that is 41 6/7 weeks is
not postterm!)
Your doctor will examine you and determine if the baby is moving around in the womb and if the amount of amniotic fluid is healthy and normal. If the baby is healthy and active, you are usually monitored until labor begins on it's own.
Tests may be done as reassurance that an overdue baby is fine and can remain in the womb. These tests include a
nonstress test, a
contraction stress test and a
biophysical profile. They are all discussed below. If signs of fetal stress are found, labor is often induced.
KEEP TAKING GOOD CARE OF YOURSELFIt's often hard to keep a positive attitude when you're overdue. But don't give up yet!
Maintain good nutrition, and keep up your fluid intake. If you can do so without and problems, get some mild exercise, like walking or swimming.
One of the best exercises you can do at this point is to exercise in the water. You can swim or do water exercises without fear of falling or losing your balance. You can even just walk back and forth in the pool!
Rest and relax now because your baby will be here soon, and you'll be very busy. Use the time to get things ready for baby so you'll be all set when you both come home from the hospital.
[NOTE: I have omitted information on postterm pregnancy, because that will not be a factor for me]
TESTS YOU MAY HAVEThe Nonstress TestA nonstress test (NST) is performed in your doctor's office or in the labor and delivery department of a hospital. While you are lying down, a technician attaches a fetal monitor to your abdomen. Every time you feel your baby move, you push a button to make a mark on a strip of monitor paper. At the same time, the monitor recods the baby's heartbeat.
When the baby moves, it's heart rate ususally goes up. Doctors use the findings from the NST to help them evaluate how well a baby is tolerating life inside the uterus. Your doctor will decide if further action is necessary.
The Contraction Stress TestA contraction stress test (CST) gives an indication of how the baby is doing and how well the baby will tolerate contractions and labor. If the baby doesn't respond well to contractions, it can be a sign of fetal stress. Some believe this test is more accurate than nonstress test in evaluating the baby's well - being.
To perform a CST, a monitor is placed on your abdomen to monitor the baby. You are attached to an I.Ve. that dispenses small amounts of the hormone oxytocin to make your uterus contract. The baby's heartbeat is monitored to see it's response to the contractions.
This test gives an indication of how well the baby will tolerate contractions and labor. If the baby doesn't respond well to the contractions, it can be a sign of fetal distress.
The Biophysical ProfileA biophysical profile is a comprehensive test used to examine the fetus during pregnancy. It helps determine fetal health and is done when there is concern about fetal well-being. The test evaluates the well-being of your baby inside your uterus.
A biophysical profile uses a particular scoring system. The first four of the five test listed below are made with ultrasound; the fifth is done with external fetal monitors. A score is given to each area. The five areas of evaluation are:
- fetal breathing movements
- fetal body movements
- fetal tone
- amount of amniotic fluid
- reactive fetal heart rate (NST)
During the test, doctors evaluate fetal "breathing" - the movement or expansion of the baby's chest inside the uterus. This score is based on the amount of fetal breathing that occurs.
Movement of the baby's body is noted. A normal score indicates normal body movements. An abnormal score is applied when there are few or no body movements during the alloted time period.
Fetal tone is evaluated similarly. Movement, or lack of movement, of the arms as lets of the baby is recorded.
Evaluation of the volume of amniotic fluid requires experience in ultrasound examination. A normal pregnancy has adequate fluid around the baby. An abnormal test indicates no amniotic fluid or decreased amniotic fluid around the baby.
Fetal heart-rate monitoring (NST) is done with external monitors. It evaluates changes in the fetal heart rate associated movement of the baby. The amount of change and number of changes in the fetal heart rate differ, depending on who is doing the test and their definition of normal.
A normal score is 2; an abnormal score is 0 for any of these tests. A score of 1 in any of the test is a middle score. From these five scores, a total score is obtained by adding all the values together. Evaluation may vary depending on the sophistication of the equipment used and the expertise of the person doing the test. The higher the score, the better the baby's condition. A lower score may cause concern about the well-being of the fetus.
If the score is low, a recommendation may be made to deliver the baby. If the score is reassuring, the test may be repeated at a later date. If results fall between these two values, the test may be repeated the following day. it depends on the circumstances of your pregnancy and the findings of the biophysical profile. Your doctor will evaluate all the information before making any decision.
INDUCING LABORThere may come a point in your pregnancy that your doctor decides to incuce labor. If this happens, it might help if you realize this is a fairly common practice. Each year, doctors induce labor for about 450,000 births. Labor is induced for overdue babies, but it is also used for a number of other reasons, including chronic high blood pressure in the mother, pre-exlampsia, gestational diabetes, intrauterine-growth restriction and Rh-isoimmunization.
As we've already discussed, when you see the doctor, you will probably have a pelvic exam. At this point in your pregnancy, it probably also includes an evaluation of how ready you are for an induction. Your doctor may use the Bishop score to help make this determination. It is a method of cervical scoring, used to predict the success of inducing labor. Scoring includes dilation, effacement, station, consistency and position of the cervix. A score is given for each point, then they are added together to give a total score. This helps the doctor decide whether to induce labor.
[NOTE: I have omitted the section about the ripening of the cervix.]
INDUCING LABORIf your doctor induces labor, you may first have your cervix ripened... then you will receive oxytocin (Pitocin) intravenously. This medication is gradually increased until contractions begin. The amount of oxytocin you receive is controlled by a pump, so you can't receive too much of it. While you receive oxytocin, you are monitored for the baby's reaction to your labor.
The oxytocin starts contractions to help you go into labor. The length of the entire process - ripening your cervix until the birth of your baby - varies from woman to woman.
It is important to realize that being induced or having an induction does not guarantee a vaginal delivery. In many instances, the induction doesn't work. In that case, a C-section is usually necessary.
Hannah and her grandad
Hannah and her Nana
Hannah and cousin Bonnie
Hannah and her grandad
Hannah's first bath at home
More first bath
Not really liking this bath thing...
Get me out of here! (Don't worry - John was standing just out of the photo too)
Very sleepy!
