The day before labor started, we had developed a new plan. The plan had been for delivery at 37 weeks, but frankly no one expected me to make it until 37 weeks. The thought was with the low fluid we would see some distress at some point during my three week hospital stay and have to deliver me. We were all pleasantly surprised how well the baby was doing. No distress. So earlier that week I asked the question- can I stay pregnant longer? Originally we thought 37 weeks was a good goal because we (in obstetrics) usually deliver women at 37 week if we discover oligohydramnios. The thought is that usually the low fluid is an early sign of distress, that the placenta is beginning to function poorly and increases the risk of stillbirth. We knew my baby’s low fluid was not a sign of distress and my baby had shown no signs distress on the monitor.
Luckily my primary MFM doc was on that week and so when I asked about potentially waiting until 39 weeks for induction, she thought there might be something to it. We weighed out the risks and benefits. Pros: the lungs might mature more, the baby would be bigger (and weight is always good for a sick baby), my cervix might be readier for induction and it gives me more time to go into labor on my own (the latter two would decrease my risk of c-section). Cons: more time on the monitor means more time for baby to show distress, possibly leading to an emergency c-section, the lung development might not be all that much between 37-39 weeks, so we might be delaying the inevitable and in theory increased risk of stillbirth due to cord accident (though being on the monitor in my mind essentially solved that). There was also the impact on me mentally and emotionally- could I survive another 2 weeks in the hospital? Would I regret not waiting the extra two weeks if the baby dies due to pulmonary hypoplasia? Would I regret waiting the two weeks if I have a stillbirth?
Ultimately we decided to wait- give her an extra two weeks. We called our families and told them of the new plan. I felt bad because some had already bought plane tickets for 37 weeks but I knew that we had to do what we thought was best for our baby. Give her the best possible chance. I wanted to look back and have no regrets on our decisions for her. I went to bed the night before labor feeling oddly happy about spending another two weeks tethered to a monitor. I got two more weeks to feel her move and grow her.
We now know Mabel had her own plans, but I’m glad we made that decision. I’m also glad that she made the decision to come on her own. If we had induced I might have always thought, what if we had waited?
I’ve been writing my birth story and I’m almost ready to share. As a midwife and as a mother whose child has died, I want to remember every second of my time in labor and my time with her. I want to get it right. I want the world to know how she came into this world and how she left it. It’s her memoir. And this decision to wait as long as possible for her is part of that story.