Labor Discussion

Just about every woman who's had more than one child has told me "don't worry, the second labor is MUCH easier..."  Since my first labor was nearly 33 hours, including 4 hours of pushing and Quinn being born via forceps resulting in a mega repair job and about 8 weeks of healing...  makes me wonder why after 2 hours of pushing, I stubbornly told my doctor that we "weren't having surgery today..."  A c-section sounds appealing compared to what I went through, no?

So I obviously needed to have a serious discussion with my OB about what I might be facing in 3 months and 6 days...

At my last appointment, we discussed a few things leading up to my water breaking and walked through the notes he had on my labor with Quinn.

"What's the point of the internal exams if the measure of dilation doesn't necessarily indicate labor is closer?"
The reason I asked this question is because my water broke but I didn't go into active labor for about 12 hours.  He said he'd consider this PROM (we'll discuss this in a bit.)  Hindsight makes me wonder if my internal exam at 39 weeks and my membranes being stripped/swept may have lead to my water breaking before my body was truly ready to have a baby.
Back to exams >> It's common practice for women to have internal exams in the last weeks of their pregnancy, I had one at 36, 38, 39+ weeks.  The 36 week internal includes a test for group B strep. My doctor also explained another objective of an internal exam is to confirm that baby is head down.  However, if I didn't want any internal exams (with the exception of the group B strep swab at 36 weeks) they could check with a quick ultrasound to make sure the baby is head down. 
My current conclusion: As far as exams go, I'm thinking this time I'm not going to have any true "internal exams." 

PROM (Premature Rupture of Membranes): Spontaneous rupture of membranes (water breaking) before the onset of labor. 
According to a few different sites I've read, this occurs in roughly 5-10% of pregnancies.  Prolonged labors with PROM (that was me) are also at risk of intrauterine infections.  I did develop a fever a few days after coming home from the hospital and needed to be put on antibiotics (which lead to other lovely stuff).  My doctor explained that there is chance I could be at risk for experiencing PROM again since I did with my first pregnancy.  Lucky Me! 
My current conclusion: You'll probably agree that this "PROM" doesn't sound as fun as the big event you prepare for in the spring of your junior and senior years of high school. So, yet another reason I will be abstaining from any internal exams.  Of course, I say that now, but... let's caveat that with, if baby isn't born by 40.5 weeks, I won't object to a little intervention in the form of an internal exam to get the show on the road. 

 

Forceps: 
In the words of my 18 month old son, "Owiee, Owiee!!!"
As I mentioned above, it took me a fair amount of time to recover from the lovely forceps delivery - my son did NOT want to be born.  I wasn't joking when I told my doctor that if we're at the point where this baby will need to come out via forceps, then I would like to opt for a c-section.  I'm sure any medically educated professional would argue with me, but until you experience forceps and a nearly 4th degree tear, you really have no say - period.  That being said, my doctor assured me that for 2nd+ time mommies who had a forceps delivery with their first child - he probably only uses forceps for a second time once a year.  This has given me soooo much confidence.  I'm ready!  Bring it!  That is, unless I'm that lucky "once a year" woman.

Final thoughts:

• Baby Size: My OB's notes from my first labor indicated that he believes my pelvis could handle delivering up to a 7.5 lb baby.  Quinn was 6.5 lbs born at exactly 40 weeks.  Another boost of confidence... even if this baby is a little bigger than Q, s/he should be able to "fit."
• Natural vs. Medicated: I had really wanted to have a natural, drug free labor with Quinn.  I was successful in this for the first 20 hours (8 of active labor), before I gave in and got the "cocktail" of benadryl and stadol (aka: the devil) at the recommendation of the nurse who said "you're not dilated more than your last appointment after 20+ hours of labor, let's give you something to rest, it's going to be a long day."  If I heard my dr correctly at this appointment, his notes indicated that I made it to nearly 9cms before getting the epidural!!  And the darn thing only worked on my left side, so why wouldn't I try to be med-free this time?!?!  I am confident I can do it!!!

I'm sure there are more thoughts on that appointment, but I think this post is long enough.  With the exception of experiencing PROM again, I am very confident in this labor.  I realize that the complications associated with PROM can lead me down a similar path to what I experienced with Quinn, but I just have a really positive feeling about this one.