Let My Baby Decide

“Hmmm” the doctor’s nurse mumbles with creases on her forehead, “the contraction is irregular and weak”.  In other words - no imminent sign of labor.  I asked the more important question, “the baby is ok, right?” to which she confirmed baby’s heart rate is normal.  That is all that matters.

Two days before my expected date of delivery (EDD) with baby Ava, I was on my last scheduled check-up at the doctor’s clinic with a contraction and fetal heart monitor strapped around my abdomen.  With the printed graphs on hand, the nurse ushered me to the doctor’s office for the ultrasound.  After all the necessary checks, the doctor informed me everything is fine but if the baby still does not come out three days after the EDD, she may proceed with induction of labor.

The word induction rang an alarming sound in my head.  I have read so much about it and it does not spell g-o-o-d.  The major concern is premature birth even if believed the baby is term.  Other risks include fetal distress, placental abruption and uterine rupture.  For someone like me who would like to go for natural birth, it goes against nature’s way of allowing the baby and mom to initiate labor.  If labor is artificially started, it means longer labor and stronger pain.  An onset of interventions is performed (e.g. I.V. drip for pitocin, fetal monitor, epidural for intense pain) which could ultimately end up in a caesarean section.

I told my doctor that three days is too soon.  I was prepared to wait for another 2 weeks, so long the baby and I continue to do fine.  That means I was not suffering from any blood pressure, diabetes or any maternal illness and that the baby does not have an abnormal heart rate pattern or that the amniotic fluid level and placenta continue to provide a healthy living environment for my baby.

That night when everything was quiet, I reassured baby Ava that I will not allow the doctor to force her out if she is not ready.  If she is still comfortable inside, so be it.  She might need the extra time to make her lungs stronger or maybe to develop any other organs more fully.  When it is the right time, she will let me know.  Mommy can wait.

In fact, it is only right that we take the time to wait and not to rely on numbers alone.  To begin with, EDD speaks rightfully of the acronym it stands for – ESTIMATED date of delivery.  It is an estimate counting 40 weeks from the first day of the last menstrual period (which we know can be irregular too).  According to Dr H. Kieler, O. Axelsson, S. Nilsson, U. Waldenströ in Ultrasound in Obstetrics & Gynecology, there is a standard deviation of 8-9 days surrounding due dates calculated with even the most accurate methods. This means that fewer than 5% of births occur at exactly 40 weeks; 50% of births are within a week of this duration, and about 80% are within 2 weeks.

Sometimes I wonder if this propensity for deadlines is born from our modern culture of fast-paced, highly scheduled lifestyle (at least in urban cities anyway).  We want to be in full control that a “wait and see” approach somehow makes us uncomfortable.   Unfortunately, expecting a birth at an estimated due date becomes just one of many.  The increasing incidence of social induction and elective caesarean is a testament to that.  These procedures are not medically necessary but rather arise from the convenience of the parents or doctor’s schedule (including that of the hospital) or for the sake of an auspicious birth date. Sadly, it is at the expense of the baby who is more likely to have medical problems compared to babies who initiated labor and delivered at full term (up to 42 weeks).  

Luckily, I was spared from the time-pressure of induced labor.  Two days after the checkup, at 5am in the morning, I was having regular contractions that grew stronger and stronger. I knew baby Ava was ready to come out.  She probably heard the doctor and got scared of the 3-day deadline, or maybe she just listened to Mommy’s gentle coaxing =)