I talked to my doctor yesterday evening about my options following the distressing ultrasound. She confirmed that she thought the baby might be large (medical term: “macrosomia”) when she had palpated my abdomen. She says she supports my desire to go forward with induction, but I can tell that she probably thinks a c-section is a wiser choice. And when I say “my desire to go forward with induction,” I don’t mean that I actually want to do that. I would prefer to go naturally above all else. But confronted with the potentially large size of this baby, if I wait any longer the hospital will take the induction option off the table and require a c-section. My doctors says that c-sections are mandatory when the baby’s size is estimated at 4,500 grams (about 10 pounds), and my baby’s estimate is 4,300 grams (9 pounds, 10 ounces). In the event I go for induction, I’ll be closely monitored and they will not attempt delivery with the vacuum or forceps if the pushing stage is prolonged due to the risk of “shoulder dystocia,” where the shoulders get stuck in the birth canal. They’d require a c-section at that point.

Tomorrow morning I’ll call my doctor and ask about a second ultrasound – I just want another one for confirmation. The baby was pretty active during it, and I’m wondering if those little snapshots they take for measurements might have been too blurry – perhaps it threw the measurements off. I really don’t know if that’s possible, but it’s worth asking about.

So back to my original problem – no progress as far as station or dilation, I found some information about how obstetricians determine the likelihood of a successful labor induction. Induction is particularly likely to lead to c-sections in nulliparous (never given birth before) women. They use a method called the “Bishop Score”:

Bishop Score

I’ve highlighted my current situation in the table above. A score of less than 5 is considered unfavorable, and my score is a whopping 3. So when I take that into account along with the potential size of the baby, it seems my odds for a c-section are pretty darned high. So I’m juggling the idea of inducing with a small chance of success and a large chance of emergency c-section, or just going for the c-section where at least I know what I’m going into and the recovery will probably be slightly easier than if I’d gone through hours of labor beforehand.

Here I am in the examination room right before yesterday’s doctor’s appointment:

Feeling just a bit uneasy!

I just returned from my doctor’s appointment. I’m so confused about everything.

Here are my stats:

• Baby is at -3 station, which is only marginally better than last week when her head evidently hadn’t even entered my pelvis
• Cervix is still closed
• 50% effaced.

We discussed induction and my doctor was going to see if there was any time available for me on Tuesday or Wednesday next week, when I’ll be 41 weeks 4/5 days. The possibility of a c-section also came up, but I’m even more afraid of that than induction.

But the BIG news is what happened after my doctor left and I went to get my ultrasound. Evidently little Julianna is measuring in at a whopping 9 lbs 10 oz. Now, I know these ultrasounds at this stage are notoriously inaccurate, but HOW inaccurate is what I’d like to know. I’m waiting for a call from the doctor to discuss it. I’m starting to wonder if I should just bite the bullet and induce earlier – like on Friday – in case she’s truly that big. At this gestation, babies gain an average of half a pound a week, so I’m looking at a 10 pounder if I wait a week and the ultrasound is accurate. I have NO idea how I could have a baby this large – no one in my family or Andrew’s was particularly large at birth. I’m wondering if I had gestational diabetes all along and it was never caught … is that possible?

I’m also wondering if her potentially large size could be a reason she hasn’t descended.

In other pregnancy news, I’ve been getting contractions all day. I’ve never had a day like this before. Nothing would make me happier than for these contractions to progress to full-on labor. I wish they’d get more painful.

Here I am at 38 weeks and 42 weeks & 3 days, respectively:

Today I am 40 weeks and 4 days pregnant. I have a doctor’s appointment this afternoon – this should be an interesting visit. We’ll check my progress and discuss an induction date. I’m really hoping I won’t need to be induced. In fact, I’ve been having some very mild contractions this morning … I’ve never had morning contractions before. And these are different – it feels like my whole stomach is steadily inflating, starting way down low and moving upward. It’s hard to tell what I’m experiencing when I’ve never gone through anything like this before. Part of me hopes this is the start of something, and the other part of me is completely freaked out by what might be in store if it is the real thing! I don’t think I’ll every truly feel ready for this. I’ve still got to load up the iPod with my “labor music.” I loaded a bunch of classical and jazz cds into iTunes last night. I wonder what I’ll actually want to listen to during the ordeal.

I just saw this on Apartment Therapy’s nursery blog, OhDeeDoh.com. I’m currently waiting for my Hotslings order to be delivered by DHL (stupid DHL, it’s been “with delivery courier” since Friday morning, and the DHL HQ here is only 10 miles away), but I had also considered a Moby Wrap. This guy does a great job demonstrating how to wear the Moby Wrap:

OK, this is kind of weird … a few of my Flickr photos of my pregnant belly have been favorited by male Flickr users. And when I go to check out their other favorites, they’re all of pregnant women. It’s creeping me out … I wish I knew that there was an innocent reason for it. Does anyone know of any GOOD reasons for someone to be interested in these kinds of photos?

Me, 40 weeks pregnant:

… and here’s Andrew at 40 weeks pregnant:

So yesterday was my due date. And still no baby. I’m going to try not to stress about it. In fact, I did a little research and found that there isn’t much to worry about. First time moms (medical term: primiparas) who are white and healthy, on average, have a gestation of 288 days, not 280 (40 weeks) as most believe. Here’s a quote from this site:

What is the “normal gestational term” for humans?

Naegele’s Rule: The standard definition for gestational term is 266 days from conception to the date of the baby’s birth. This is also defined as 280 days, or 40 weeks, from the first day of the mother’s last menstrual period, a definition which assumes that the mother ovulates on day 14 of a 28 day menstrual cycle. The formula used to calculate due date is:

(LMP + 7 days) – 3 months = Due Date

This definition is based on observations, first reported by Franz Naegele in 1812, who believed that pregnancy lasted ten lunar months from the last menstrual period. It was not based on empirical data.

Mittendorf’s Observations of Gestational Term. In the 1980’s, Mittendorf noticed that birth dates for women in his practice, primarily second-generation Irish-Americans, averaged seven days past their “due dates”. He reviewed his records, then went on to review records of 17,000 births, and determined the average healthy, white, private-care, primiparous woman averaged 288 days from LMP to birth: 8 days longer than Naegele’s rule. Mittendorf and other researchers have further determined several factors that affect gestational term, including ethnicity, parity, nutrition, substance use, mother’s age, and mother’s size. Based on Mittendorf’s data, a more appropriate formula might be:

(LMP – 3 months) + 15* Days = Due Date

* Add 10, rather than 15, if mother is non-white, or multiparous

The good news is I THINK I’m making progress toward delivering this baby. I’ve had weird cramps for the last 2 weeks, and they’ve become a daily occurrence. The doctor confirmed that they must be Braxton Hicks, and everything I’ve read about what they feel like seems to confirm it as well. It’s like a weird charlie-horse/funny bone feeling deep and low in my abdomen – practically in my groin. My stomach appears to harden with each cramp, too. It’s only mildly painful – maybe a 1.5 on a scale of 1 – 10.

One more day to go and Julianna is evidently still content to remain inside of me. I’ve always been enormously afraid of labor, so I guess the good thing about possibly going overdue is that I’ll just want it so badly I’ll forget about the pain I’ll be facing. Andrew and I went to see “Enchanted” at the movies last night … during the movie, I had a round of contractions which I hoped might lead to something, but they petered out after an hour. I understand these practice contractions are supposed to be preparing my body for labor, but why are my stats (baby not descended, 0 dilation and only a little effaced) so poor? I guess I’ll have to wait until Tuesday’s appointment to see if I’ve made any progress.

I thought there was a resemblance between Andrew as a baby and Julianna at 31 weeks gestation, so I decided to morph their images: