An Aching Back Isn’t A Reason For An Early Induction

There are so many things that I like about my new job. I mean, I get to assist in bringing new babies into this world! I get to pass on wisdom and knowledge about caring for a tiny human being to new parents! I have the chance to hold a laboring woman’s hand and tell her that yes, she is capable of performing this incredible act of human endurance and strength.

But it’s not all sunshine and soft baby butts, either.

I can list several things that aren’t so pleasant about my job, too. Like the incessant charting of nearly every detail that we must perform, thanks to our litigious society. Or performing vaginal exams to check for cervical dilation – which is actually kind of exciting, until you think about the fact that you spend your day with your hand in other women’s vaginas.

There is one particular part of my job that I truly dislike, however. Actually, it’s not so much an aspect of my job as it is a type of patient. I’d like to tell you all that this type of patient is rare, but in my two months on the job I’ve already seen this type of patient appear at our doors several times.

(And for those who don’t know, for the sake of privacy and HIPPA, I won’t ever be telling detailed stories about individual patients. Any stories I share will be vague enough to remove all identifying information, or will likely be several stories combined into one sample patient.)

The patient type I am talking about is the woman who wants us to admit her and deliver her baby right away for no other reason than she’s sick of being pregnant. And she’s not even full-term yet.

I’ve seen women at 32 weeks declare that all they need from us is a little pitocin so they can get this baby out. When you try to explain to this patient that her baby is still too small to be born, and would likely face a number of problems if born now, you’re dismissed and told that “My sister had a baby at 32 weeks and he’s fine!”

No amount of education gets through to some of them. They’re tired of being pregnant and want that baby out now, even though the pregnancy has no complications and there are no reasons to induce. Their own comfort is considered more important than the health and well-being of the baby they’re carrying.

It takes a lot to make me really angry, but this patient type often does stir up at least some small fury from deep within. I try to talk to them. I make every effort to explain why feeling “as big as a whale” is not a justification for a preterm birth. I remind them of the possibility of a stay in the NICU if their baby is born too young. I’m stunned by how often they brush all of the facts aside because, “I’m sooooo tiiiiirrred!”

I know too many people who had a premature birth forced upon them, some with good outcomes, some with tragic outcomes. My own mother still makes yearly visits to the grave of the daughter she lost at 32 weeks, born too soon 34 years ago. Does she wish she could have kept that baby in her a little longer? Hell yes.

Now, I remember I had my own share of complaining about the third trimester of pregnancy. Those of you who were reading when I was pregnant with Mira will remember that I was pretty fed up with being pregnant. But in no way did I ever consider the possibility of wanting to be induced just to get it over with sooner. Babies come out when they want to come out. And Mira waited until a full week after my due date to make her appearance. My doctor was impressed with my patience. Honestly, I was a little impressed, too.

Cordy was a scheduled c-section at 38 weeks because she was breech, and I’m still beating myself up over letting the doctor schedule it so early. I remember how angry she was, how even though she was a term baby, she wasn’t ready to come out yet. She wasn’t ready to feed, making all efforts at breastfeeding incredibly frustrating for both of us.

Despite my exasperation with patients who come to us hoping to hear the magic word “induction” because they’re tired of being pregnant, I still give them the same care I would any other patient. In fact, they often get even more of my attention, because I want to make sure they understand the seriousness of premature birth, and that just because we have the technology to grant them an early birth and provide support to a premature baby doesn’t mean we should use it if we don’t need to.

So we hook her up to the monitor, we check for any sign of contractions, check for good fetal movement and heart rate, check for any evidence of her water breaking, and if there’s nothing to be concerned about, send her home. This patient is never happy with that outcome, and the nurses are often called bitches quietly (or not-so-quietly) as they walk out the door. Like we’re trying to make them miserable for our own amusement.

I can handle that, though. Being called a bitch to keep that baby cookin’ just a little longer is fine with me. Because no matter the patient that walks in, my goal, and the goal of any nurse in my unit is the same: a healthy mom and baby.



Make A Wish

I don’t know what she wished for, but when I asked Cordy if we could sing Happy Birthday to her on Saturday and she said yes, I got my wish.

Cordy’s Fifth Birthday from Christina M on Vimeo.

I can’t even begin to tell you how much progress is wrapped up in that one little song and her reactions to it. It was the main topic of conversation among family for the remainder of the party.

(And this year’s cake was different, too. We avoided the usual cake, filled with artificial ingredients and enough artificial dye to turn the Scioto River red, in favor of an organic cake, with real buttercream frosting, no artificial ingredients, no HFCS, and dyes make from all-natural sources. For the first time at a birthday party, Cordy didn’t get sick or have a meltdown after eating her cake.)

It was a great party.



They Tried To Make Me Go To TV Rehab…

…and I said, “No, now pass the remote!”

Here’s how my Monday evening played out:

8:00 pm – Make sure Heroes and House are recording on the Tivo, then Aaron and I rush upstairs to the other TV to turn on How I Met Your Mother.

8:30 pm – Run back downstairs and boot up Aaron’s computer to watch the True Blood finale that we haven’t had a chance to watch until now.

9:30 pm – Back to the upstairs TV again. House and Heroes are two hour premieres tonight, so the Tivo is still tied up downstairs. Watch Big Bang Theory premiere.

10:00 pm – Return to the downstairs again to watch the season opener of Castle.

11:00 pm – Aaron and I have a brief discussion over whether to watch House or Heroes tonight. House wins this time. Fire up the Tivo and watch House. Heroes will have to wait until tomorrow night.

The sad part is, that’s only Monday. You don’t want to know what my Tivo’s schedule looks like for the rest of the week. Let’s just say it’s a good thing we have a dual-tuner. And weekends to catch up.



Five

Five years ago, you were somewhat of an abstract being to me. I had no idea what was coming, and no matter how many babies I was around, it couldn’t have prepared me.

My first impression of you was the angry baby being carried past me in the operating room. Your face was screwed up in an awful expression, angry at what you considered an untimely birth, angry at the doctor who pulled you out of your warm comfortable home into the bright, cold world. You spent the next six months angry at the world, and it took every ounce of strength and patience from your father and me to calm you, comfort you, and show you that life wasn’t as bad as you thought it was.

Each subsequent birthday has presented us with a different child. Your first birthday, you were the girl who loved all the attention, but loved the cake even more as you attempted to eat the cake without hands by face-planting into it.

At two you shunned the crowd and most of the presents in favor of the safety of my lap and a few selected toys.

Three was a child who howled in pain when we sang happy birthday to you, hiding under the table to escape the auditory assault, only to later reappear and gorge yourself on the cake frosting.

Your fourth birthday was filled with balloons and friends, and this time you took notice of the friends around you, although you still didn’t want to share your balloons. We knew you didn’t like singing, so we settled for all saying “Happy birthday!” in unison, at a loud, but not-too-loud volume for you.

And now you’re five.

At this year’s birthday party, I expect to see you playing with your friends and if not enjoying the small crowd of people, at least tolerating your guests. You will tell me or your father when you feel overwhelmed, and even though it will likely come out as, “I’m scared of presents” or “I want to stay in my house forever,” we will know what you mean. You’ll eat your cake, and if all goes as planned you won’t suffer from a tummy ache or a behavior shift thirty minutes later because this year’s cake won’t have any artificial dyes or corn syrup in it. We now know what you need to be happy.

I still can’t believe you’re five. Five feels so much older, as if I somehow missed that transformation from baby to big kid. I watch your concentration on puzzles, and I swear I can see your mind working behind that furrowed brow. When did you learn to concentrate? I wonder what happened to that goofy toddler I remember, counting everything in sight.

And I’ll confess I don’t wonder much about what happened to that sensitive, hair-trigger tempered preschooler and the screaming meltdowns that occurred on a regular basis. Some things are better left in the past.

I’m pretty amazed at the awesome little girl you’ve become, Cordelia. I can’t wait to see who you’ll become in this next year. Happy birthday to my Amazon warrior princess.



Wishful Thinking

As I was kneeling down in front of Cordy yesterday, talking about some topic I can’t even remember, I noticed her eyes suddenly fixed on mine.

Eye contact is hard for her, so I was amazed at how intensely she was looking into my eyes. For at least 15 seconds she was staring directly at me while I talked to her.

OMG, she is making so much progress! I thought. I was thrilled that she was not only listening to me, but looking at me while I talked to her, a task we’ve tried to get her to do with limited success.

I couldn’t contain myself any longer. “Cordy, I’m so proud of you for looking at me while — “

“Mommy! I can see myself in your eyes! I see Cordy!”

Oh.

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