Patience....

Fair warning... this post is a bit lengthy.

Yes, we are still pregnant. Yes, our ESTIMATED due date (note I said ESTIMATED not expiration) came and went. Yes, believe it or not, it is ok. No, there is no intention or plan to induce at this point. "What the?" you say. Keep reading...


First, we have a lot of faith. 

Faith in ourselves. That we are intelligent, responsible, educated, highly informed people who have put LOTS of time and effort into learning and researching and making the best, safest choices for our baby in our particular circumstances. We have not wandered blindly through our pregnancy, nor are we un- or under-informed about our current "overdue" status. We are constantly weighing the benefits vs. risks of our options as our pregnancy progresses and will act accordingly. Right now, there is no medical indication that anything needs to be done. I am healthy, baby is healthy. So, we are making every effort to have patience. No two marriages, no two women, no two pregnancies, no two babies, and no two births are the same, thus, there are no medical protocols that fit everyone (contrary to common perceptions and medical practices). Our choices may not be right for you and visa versa, but I urge you, educate yourself, and be your own advocate.
"If you don't know your options, you don't have any." Diana Korte and Roberta Scaer, authors of A Good Birth, A Safe Birth


Faith in our care providers. A wonderful, caring group of Ivy-league educated professionals who educate, advise, and advocate rather than dictate. They combine a strong belief in the natural physiological process of pregnancy and birth with the safety-net of western medicine. They practice medicine based on current, modern research findings rather than standard protocols implemented long ago and though thought safe a the time, many of which have been found to NOT be safe or beneficial, or only so in very specific circumstances, NOT across the board or for the sake of convenience.

Faith in our doula. From her website: "A doula is someone who supports pregnant/laboring women emotionally, physically, and with sound information during her pregnancy and the birth of her child. A doula assists in educating a pregnant woman with knowledge of risks and benefits allowing her to weigh her options when it matters most.  As your doula, I am your assistant and advocate, I will impart information and make sure your wishes are met, but will not make decisions for you.  Whether you want to birth at home, in a birth center, or in a hospital, I will work in harmony with you and your caregivers to ensure that you, your family, and your baby are well cared for.  A doula may not make diagnoses or perform medical treatments or techniques." She has been an invaluable addition to our team of caregivers because of her wealth of knowledge and information, and because she has no other agenda than to take care of us. She has no obligation to anyone but us, not the hospital, not the doctors, her only priority is supporting us through this process.


Faith in God, nature, and the natural process. Baby will come when he's ready. Women have been delivering babies via spontaneous, natural labors for thousands of years. In fact, depending on your age, many of our mothers, and most of our grandmothers did so successfully. Only fairly recently has intervention and intensive management of pregnancy and birth become so popular. Unfortunately, if you look at the statistics, and look at the outcomes (maternal and fetal morbidity and mortality, i.e. injury and death), societies that believe in and practice care based upon the natural process have significantly better outcomes than those who practice high-tech, intensely managed, highly interventionist care--like is prevalent in the US. Does modern medicine save lives of mothers and babies? Absolutely. Do MOST mothers and babies need "saved" from the "perils" of pregnancy and birth? Absolutely NOT. The research, literature, and facts are there. What you choose to seek, see, and to believe is up to you.


Now, on to the business of being "overdue".


From Henci Goer's "The Thinking Woman's Guide to a Better Birth"


"A better term than overdue would be the medically correct postdates. "Overdue" implies that going past your due date is a problem, rather like overbaking a cake. On the contrary, inducing for exceeding your due date is a textbook case of how mainstream obstetric care keeps narrowing the definition of normal until practically no one fits, which then creates the "need" for intervention. True, a small percentage of women don't begin labor when they are supposed to. And, yes, placentas are not made to last forever. Still, mainstream postdates management has little scientific basis.
Up to the late 1980's, conventional obstetric wisdom held that if pregnancy continued two weeks past the forty-week due date, either labor should be induced or some sort of periodic testing of fetal well-being should be done. Nonetheless, induction [not testing] became the norm."
"There are problems with the due date itself. You may be surprised to learn that the conventional forty-week pregnancy length is completely arbitrary. It was established by a German obstetrician in the early 1800's. He simply declared that a pregnancy should last ten moon months, that is, ten months of four weeks each. However, when researchers in a 1990 study followed a group of healthy, white women, they discovered that pregnancy in first-time mothers averaged eight days longer than this."
"In addition, ultrasonography, the current standard for assigning due dates, does not reliably do so accurately."
"It gets worse. While even the forty-two week limit isn't sound, in recent years the "time's up" date has backed up to forty-one weeks, and then forty weeks. " Thus "first-time mothers are not only NOT "late" at forty-one weeks, they haven't even reached the average pregnancy length."


Ok, Laci, we get it, so maybe you aren't medically "overdue"... but still, why not induce? Lots of people do and everything turns out fine. Get that little man here because we are all dying to meet him!!

Well, here's the deal. The day I found out we were pregnant, my world almost altogether ceased to be about me, and began revolving around what's best for this baby. It wasn't a conscious shift, it just happened, and for awhile, I didn't even realize it. 


The Cascade Effect: a vicious cycle, why we are choosing to avoid interventions if possible.


It's all about chance. Even if something has only a small percent chance of negative effect, meaning most people who use it turn out fine, I don't want to be that small percent affected negatively. So, by choosing to avoid unnecessary intervention, I reduce my chance of negative side effects from that intervention to zero. If it turns out we need it... ok. But why risk it if we don't need it?

Every intervention (i.e. things like continuous fetal monitoring, iv's, disallowing food/drink during labor, inductions, pain meds, episiotomy, cesarean, etc.) comes with a surprising and scary list of possible risks and negative side effects. I won't get into all of them, you all know how to google. The bigger problem is what's called the Cascade Effect: one seemingly harmless intervention has a side effect, that requires another intervention to fix it, that has another effect, that required another intervention.... you get the idea... that eventually leads to cesarean section. Cesarean section... MAJOR SURGERY-the most common major surgery in the US-that comes with a whole host of possible negative side effects including increased chance of maternal or fetal death! Ok, yes, it sounds dramatic, but it is true.


Inductions increase the risk of fetal distress leading to cesarean, problems that are then attributed to the baby's condition rather than their real cause--the induction itself. Unlike the natural process in which contractions begin slowly and then increase in duration, frequency, and strength, induced contractions start out long, strong, and frequent posing the risk of compressing the umbilical cord (among other potential problems, like failure of the induction altogether), and viola, fetal distress, that can lead to c-section. Natural, spontaneous labor allows the mother's and baby's bodies time to produce pain blocking endorphins and other chemicals and hormones to cope with the stress and pain of labor. The human body comes fully equipped with impressive coping mechanisms. Induced labor doesn't allow this and the body's coping mechanisms can't keep up. Leading to use of pain medications and all of the potential side effects they carry with them (again, you can google), often leading to what? You guessed it, fetal distress, and c-section.

Do these scenarios always come true? Of course not. Are they common enough to be cause for concern? Yes.


The bottom line.


We are not crazed radicals who are refusing necessary medical care. We have great doctors and support people and are planning to deliver in a state-of-the-art hospital fully equipped and prepared to handle any complications. I am healthy, baby is healthy, and we are being monitored closely for any problems that could arise. If things change, our plan will change accordingly. The goal is to have the healthiest happiest baby we can, and part of achieving that goal is to minimize risks, and especially to avoid choosing options that increase risks. We are excited to welcome our little man into the world and can't wait for his arrival, and are 1000% confident that we are making the best possible decisions for us and our circumstances!!

Am I huge and uncomfortable. YES. Enough to take unnecessary risks. NO. So... until his debut... patience. :)