About last night

So here's what happened yesterday. We had our two appointments as detailed in our last post. Everything was great, and had an unlimited parking spot, so we went and caught an early dinner on campus with Sandy. Before long, though, we got a call from the Perinatal Observation Unit, which is right upstairs from the testing office in the Ravdin building -- it is in fact right next door to the Labor & Delivery Ward. Anyway, the call was for Dr. Wu, who had not been with us earlier. Evidently, the nurse who told us we should go home screwed up -- possibly, she was just trying to go home herself. Dr. Wu wanted us to come back for another hour or so of monitoring based on something she saw in the stress test. We asked if it was urgent, and she said no, we could take our time coming back -- frankly, we wanted Carolyn to finish her dinner, because it's impossible to get them to feed you once you're back in the hospital.

So back to the Perinatal unit, which, by the way, has a registration process that is longer than every other registration we've done combined, in 40 visits to various offices over the past eight months. This is our third trip to this unit, the other two being when Carolyn had a small stumble and they wanted to monitor things as a precaution. This is what this unit does -- they strap on a bunch of stuff and do HOURS or monitoring.

So what was it? Well, there were a few seconds where Junior's heart rate had dipped just a little bit. The actual heart-rate dipping was inconsequential and not cause for any concern, in and of itself -- Junior was totally fine. The warning flag was the timing of the dips, which was immediately following a small contraction. That apparently is an indicator that the placenta might be getting a little long in the tooth -- and at 40 weeks plus, who can blame it? (If you think about it, the placenta's function is pretty incredible. It is essentially the same thing as The Patch, except that instead of nicotine, it provides all of your food and oxygen.)

So Junior was totally fine and in no imminent danger, but this is just a small risk indicator, that maybe at some point, the placenta would start functioning less efficiently. And the thing is -- this is the key factor in inducing -- there is no real reason NOT to induce at that point. I mean, you might rather go into labor 100% naturally, but the baby is already "ripe" at that point and not getting any riper. As the doctor put it, once you're late, you're almost waiting for something to go wrong.

So they checked us in to labor & delivery, and around 11:00 p.m., they started a very slow induction process. The idea is to bring the cervix along slowly, to get it ready first before administering the pitocin, which is what really gets the contractions going. The more gradual the induction process is, the more similar it is to a natural labor process, which greatly reduces the chance of a C-section later on. So the plan was to take two to six hours before getting the pitocin going, and though we tried to get some rest during this time, we couldn't get too much. Carolyn's contractions suddenly got a lot worse right around 2:00 a.m., and by 2:30 a.m., we were requesting the epidural. This was always part of our plan, but Carolyn figured she might wait later in the process.

In retrospect, knowing that inductions can involve much more violent contractions, we probably should have started it earlier. As it is, we ended up behind two somewhat problematic patients in the anesthesiologist's queue, so she didn't even get to work on Carolyn's for over two hours — 135 minutes, actually, and yes, we were keeping track. That last 90 minutes was pretty rough. Carolyn was a trooper, though, and once the anesthesiologist started working on her, she was able to deal a lot better with the pain, knowing it was going to go away soon. It took about 30 minutes to hook up, and there was some improvement immediately. By 5:30 a.m., there was no pain anymore at all, and we got some real sleep over the next few hours.