Tuesday, August 01, 2006

The Best-Laid "Plans"

So last week we took our tour of the Birth Center at the new town hospital. It was called a "birth plan appointment," but this seemed a little...unnecessary...in my case, since I am supposed to be having a scheduled C-section. You know: the nurse was asking all sorts of questions about what "comfort measures" I wanted, etc., and I kept saying, "Well, I'm not actually going to be laboring, so...."

Anyway, a couple of things were a bit unnerving, so I was glad to see my own OB this morning and get some clarification. Or at least make sure everyone's on the same page here. Specifically: at the birth plan appointment, the LPN went over the guidelines as to when I should call the Birth Center, should I go into labor (i.e., before my C-section date)--the usual "when contractions are 3 to 5 minutes apart for an hour's duration and it's hard to speak during them." I asked her, "Since I'm supposed to have a C-section, shouldn't I just call as soon as it's obvious I'm in labor?" "Um, no, I think you'd probably want to still wait until contractions are 3 to 5 minutes apart," the nurse said. I looked at her dubiously but let it slide.

Then a little later on she said something about how, since I'm not a "repeat C-section," unless my OB provided a written order that I am to undergo a Cesarean, the staff might hesitate to do one were I to go into labor before my surgery date. "They probably wouldn't understand why you'd be having a C-section, and you might be encouraged to labor," this nurse explained. (I should explain here that it is a bit unusual for a woman to have a C-section after a first vaginal birth, unless the baby is breech or there is some other immediately obvious medical complication going on; however, I am indicated for one due to extreme physical trauma from my first delivery and the high risk of further, permanent bodily damage--something that would only be apparent were one to read my entire chart, including my records from my former hospital.)

Of course here is where, in my mind, I am thinking, You've seen my chart, right? Are you guys even talking to each other? It all reminded me just a little too much of the part in Waiting for Birdy when the clinic staff keep asking Catherine to sign a consent-for-vaginal-birth form at each of her OB appointments, even though she keeps saying, "You guys know I'm having a C-section, right? I mean, someone will be there waiting for me and everything?" Yeah. Exactly.

Thankfully, when I ran all this past my own doctor this morning, she rolled her eyes, asked who I had spoken to, and wrote in big bold letters at the top of my chart, "Pt. scheduled for primary C/S!" with an asterisk next to it. Then she assured me that all would be done according to plan, and also, to call the Birth Center as soon as it becomes clear to me that contractions are, indeed, labor and not Braxton-Hicks. "It makes no sense to wait until they're close together," she said. "Call when they're regular, even if they're 10 minutes apart. We're going to do a C-section." Thank you! Of course, this may all (please!) be a moot point if labor does not begin prior to my surgery date. But sheesh, could everyone just please get their stories straight?

In other news, I'll have those of you who recently ribbed me about my astronomical belly size know that my OB--yes, the same one who laughed her head off at my 21-week appointment because she thought my uterus size was "generous"--said she doesn't think I look unusually large at all, that to her I look--and measure--exactly 35 weeks pregnant, and that compared to how she looked at 24 WEEKS ALONG with her third baby (yikes!), I look downright small. She also said that next week at the ultrasound she'll give us a good guess as to the baby's size.

Think I have time to sneak in a few more Blizzards before then? You know, add a few ounces onto Little Miss Thing between now and next Tuesday? Though, I recall now, my OB also said that her last baby, the one who made her belly so humongous at only 24 weeks? Yeah, that baby was 9-1/2 lbs. at birth. Yowza!

No comments: