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Unstable lay at 37 weeks 4 days...

Posts: 61
2/25/09 10:00 A

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It looks like you got some good answers and you are doing squats like I was going to suggest.

I have had 4 births- 1 was "almost" without drugs (I had Nubain with my first) and I did AROM (didn't check that out before hand and had NO idea of all the risks but it ended up ok.) I also had an episiotomy even though I didn't want one- but the Dr said I "had" to. (long story- it wasn't my dr, as she was out of town and I had her back up- a guy that I had never seen before!) But at that point, I was exhausted and just wanted the baby out! LOL He was born vaginally but it was all wrong for me, because I "caved". Later I learned that my pain was due to serious back labor and once I learned how to deal with it I was better! So my 2nd birth I chose to try a water birth. This birth was the only time my water broke on its own. I was in the birthing tub and I felt a "pop". It was so weird! Then with #3 I had to have AROM at 8-9 cm because he was still high and the mw was worried about cord prolapse and then an emergency CS. (Definitely not what I wanted!) Then with my 4th I was 8 cm when I got to the hospital again- this happened with #2, #3 and 4 LOL and they called her right away and just about a half an hour after I got there, she broke my water and I was probably at 9 by that point. They broke it because they wanted to make sure it was clear (hospital thing I think) and I think she was a little high up as well and my bag was bulging. So then I got in the tub and I was in for probably 45 minutes or so and she was born within about an HOUR AND A HALF after I arrived at the hospital. I had the midwife home in time for dinner :)She said that was one of the easiest I make things easy! They don't have to do much- and I even caught my daughter this time- that was so awesome.

Anyway- I was just saying that AROM is not that terrible- even though it wasn't my first choice...if you wait until after 7 cm, it more than likely won't cause unnecessary issues and complications I think. (not a scientific fact- just my opinion! lol) I would say if you can, wait until 8 cm or 9 unless they say otherwise. I probably wouldn't do it earlier than 5-6 cm . For me, it possibly helped avoid cord prolapse.

I don't know much about doing an amnio but it sounds like a possibility to help drain your excess fluid. I hope your little baby stays in vertex, and that the extra fluid can be drained somehow. I would research that more. I think it is nice that you found a supportive OBGYN too! There needs to be more! Natural labor is AWESOME= less complications. Good labor vibes to you and I hope you get the birth you want!

Francine- Mom to 3 boys, ages 8, 6, and 3.5 and a girl born 6-7-08, in my hands in water...and expecting a surprise #5 in October 2009! Planning my 4th water birth, with a midwife (in a hospital).

Posts: 496
2/21/09 11:16 A

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Carrie- glad to hear that you think that there might be something in the amnio idea.
Will persue. I like it cause it addresses the root of the problem without (hopefully) disturbing the baby and my bodies timing.
Especially since LO is really REALLY down low today- she had hiccups and DH and DS had to put their hands almost under my pubic bone in order to feel them! A very good sign I think :) I knew that she would find her way there if the fluid gave her time before breaking! Now if we can siphon off some of this fluid then we'll be in a great place to await nature...

Posts: 12266
2/21/09 11:00 A

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if it were me I'd be on board with the amnio.

it sounds promising but as the mom you would want to discuss this with the dr more.

BabyFit Community Team
momx5, birthteacher, doula

Posts: 496
2/21/09 8:28 A

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You ladies are amazing, thank you so much for your responses!
Please read my new question for you at the end! Thanks again, I feel so supported by your responses and releived to read some like minds.

Carrie- They are looking at 39 weeks instead of 40 for the AROM because the excess fluid increases the chances of my water breaking on it's own by a great deal and that would be an emergency situation and would risk a prolapsed cord and even with/without prolapse would most likely lead to an emergency CS . This is my second pregnancy and my son came 2 days after the EDD so they are doing the best they can to guess how long I have with this added fluid pressure.

I will look into a foley cath- never heard of one but will persue, thank you. I have no progression now (38 weeks tomorrow) so who knows by 39 weeks...

As baby grows it will increase her chances of staying vertex- I can feel the difference in her size when she moves every few days. I'm eating as well as I can but it's tough with having a water balloon sitting on my tummy as well as a baby! And my fluid is slowing increasing too... Even if she does stay vertex we have a problem with the fluid making for a possibly unstable lie for her during labor so I think that if labor started on it's own (yes, please!) that they would still wish to AROM just to settle her. But at least labor would have begun on it's own!

Binding would keep her from moving into the footling and frank positions but she's mighty fond of transverse, too? Also- might it not increase chance of waters breaking? I don't know... I'm sitting on a high pressure water balloon!

Rae- I do indeed squat every time after I do the slanting board and/or any other time I am pretty certain that she is head down. They say that they don't expect her to engage until labor beigns (second baby/excess fluid) but I'm hoping!

Anne- Yes, relax. Thank you. I am getting there. Feel much calmer today, am finding that I do indeed have faith that she will be fine and that this will all work out beautifully. There is only so much 'planning' one can do, you know? Ultimately if I trust my body and my baby and my providers then, one way or other, all will be well.
I do think that she will turn vertex if labor begins- if my waters can just hang in there until then.

There is one other idea that has been floated (no pun, little baby :) and appeals to me- what do you all think of this....
The OBGYN (VERY midwife supportive) whom I have brought on board has had this suggestion- that when baby is vertex (either through a version or I'm sure that I could get her there by doing a slanting board with some schubert just before...) they would remove the excess fluid by amnio and then I would be left to go home and allow labor to being on it's own, as it normally would.... What do you think? It has definite advantages, don't you think? It would make my pregnancy 'normal'- it would be a hospital room birth when it happened but would be with midwives and I progressed quickly (4cm-10cm in an hour) with my son so I don't think that there would be any 'need' for pit if labor had started on it's own and waters broke naturally during labor...

Posts: 9168
2/20/09 10:39 A

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Maybe once baby is vertex, doing deep squatting to get baby engaged?

Jack Finley: Homebirthed, Waterbirthed, Non-circumcised, hardly vaccinated, exclusively breastfed, cloth diapered and perfect in every way!

Posts: 12266
2/20/09 10:27 A

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I do understand the reason for the induction by AROM in this case. it IS one of the sitautions where AROM can be beneficial!

I do wonder why they are choosing 39 weeks and not 40?

Is is because the chances that you would not have begun labor are greater? If so, that also means that is less likely that the induction will work without augmentation.

Would they consider also using a foley cath to help with proglastin production and more labor more natural" (well, more natural and less risky they Pitocin or cervidil, anyways. You'd be producing the contractions)?!

I less invasive method might be to grow a larger baby (200 extra calories per day from milk protein sources) while doing OFP to encourage a vertex lie (slant board? any position that allows your belly to be in the position of a sling for the baby). I've also read somewhere about binding the top of the uterus (using a long narrow cloth wrapped from your breasts down) to try to make your uterus smaller. I don't know how well it works, it's one of the things they used to used for Oolghydraminos (sp to be sure lol!) when breaking the water was seen every by drs as too dang risky.

But induction is still giving you a chance at a normal birth, even if it isn't exactly what you wanted!

I'mheaded to classes now, but will think about this and see what else I can come up with!

BabyFit Community Team
momx5, birthteacher, doula

Posts: 496
2/19/09 1:35 P

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Due to slightly elevated amniotic fluid levels (AFI 25/26) LO has a lot of swimming room and is quite happily hitting just about every possible position within every single day. This includes head down, of course, but there is no guarentee that she'll stay in that position when she does choose to be so. Yesterday, for example, she was transverse at 9:30am at the midwives and footling breech by 11 at a wet read...and by 4am this morning was head down...
Anyone been in this position? Anyone have any advice?
I am hoping to deliver at a birthing center with a midwife but unless LO for some reason decided to find a stable lay then that will not be possible. I am doing everything I can to encourage a stable lay- LO responds beautifully to my lying on a slanting board with flashlight/music/hot-cold packs etc but again, any advice for ways to encourage her to stay put is most welcome.
If LO's lay continues to be unstable then the midwife has said that she could deliver me in the hospital but would want to attempt a version followed by induction by AROM at 39 weeks. Once that happens then I would be stuck at the hosptial and would not be allowed to move to the birthing center. I would have 8 feet of cord on the heart monitor to move around with. I would not be allowed in the water until 9 cm. They would only give me 8 hours to see if labor begins before starting pit.
Of course I would do everything possible to avoid pit and would have full determination to not have an epi if pit were deemed 'necessary'.
It all sounds miserable to me but not as miserable as a CS. Better alternatives sought, please?!

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