I need induction help please - Mothering Forums

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#1 of 26 Old 09-08-2008, 08:20 PM - Thread Starter
 
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Hey mamas, no flames please, just constructive words of advice if you have them.

I've apparently developed pre-e (I've been struggling with PIH for about five or six weeks now and am now spilling protein.)

My doctor is so not concerned about the baby - she's doing awesome and is totally healthy. She's passed both biophysical profiles with perfect scores and had a great NST today. (Side note, during the u/s, we got to see both of her little feet and counted ten toes!) She's practicing her breathing and still has plenty of fluid and my placenta looks great.

So the doctor is much more concerned for my health and not her's. I've been on BP meds for two weeks now and they're having a minimal effect on my BP - it keeps creeping slowly up and will only continue to go up the closer I get to delivery. (The average today was 130/90 - that's three different readings over two hours.)

The doctor wants me to go to the hospital Thursday morning and they'll prep my cervix with Prepidil and hope I start having some contractions. (If I'm totally honest with myself, I know they'll probably throw in some Pitocin because I know they want to see how I do with contractions.)

Worst case scenario: my BP goes up during contractions and I don't handle it well - they'll keep me Thursday night and start a "real" induction Friday morning.

Best case scenario: my body handles the contractions, they discharge me Thursday afternoon and I go into labor "naturally" during the weekend.

Mixed case scenario: I do okay with the contractions, they discharge me, and nothing happens over the weekend. I have an appointment with my doctor for Monday morning and they'll re-evaluate me and either try some more Prepidil on Tuesday morning or, if I've made more progress, a full fledged induction Tuesday morning. Although my doctor is a really, really reasonable man and hates inductions, so I think if I've made progress by Monday and my BP appears stable and no extra protein in my urine, he probably would let me go a few more days without more interventions.

Anyway, so the long story short is, I know all of these things are just opening the door for more interventions and I'm scared of what I'm getting myself in to. However, I also know that my body isn't healthy right now and that my health and my baby's health are linked and I don't want to do anything to endanger her (or myself, but I'm more concerned about her.)

I trust my doctor and I know he's not concerned over nothing and he's not an alarmist. So when he tells me it's not healthy for me to carry to 40 weeks, I believe him.

I just, I just don't know what to do. My gut is telling me that I'm a healthy person (not pregnant) and that what my body is doing isn't normal or healthy for me and that I need to do something about it. My head though is telling me that all of this is what I've struggled so hard to resist - all these interventions are just going to lead me to an inevitable c-section.

Any advice mamas? I'm in an emotionally fragile state right now as this was not the news I was expecting today (to say the least.) If you think for my health that an induction is a good way to go - any at home induction advice you can offer would be greatly, greatly appreciated.

My body does appear to be preparing for labor - baby is head down, engaged and I'm 1 cm dilated and 50% effaced - for what all that is worth.

kati , wife to josh , mama to j&d (7.31.07) marion (9.18.08), feeder of nanuq and gracie lou
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#2 of 26 Old 09-08-2008, 08:34 PM
 
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Sorry this is happening to you. The good thing is that we have medical interventions for when things similar to your situation are happening.

I honestly don't think that any at-home induction methods are going to put you into labor unless you are literally within hours of starting labor naturally.

And with this being your first baby (is that right?) the baby's head being engaged and being dilated is totally normal to happen a couple weeks before labor ever starts.

I am a huge NCB advocate and homebirther. So with this in mind:

You know your doc and the situation. I don't think that you should allow the fear of further interventions keep you from starting a necessary induction for health reasons.

I understand your fear of interventions, I have them also...but I don't think that we should let our emotions override our logical thinking.
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#3 of 26 Old 09-08-2008, 08:34 PM
 
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You are so wise to try to gather more information and support. I think researching this stuff helps us feel more on board since we become educated about the process.

Though is sounds like you trust your MD and his judgement, it doesn't sound like you are at peace with the plan your doctor has. Perhaps if you thought of some more questions to ask to clarify what exactly will happen in each scenario and then also some moms find it helpful to ask what the repercutions are if you go with an alternate plan ...maybe you want to wait a few more days to be induced such as on the following Monday.

I don't know if this helps but good luck!
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#4 of 26 Old 09-08-2008, 08:42 PM
 
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nak but,



you are approaching this with a great perspective - do you have a doula or friend to bring with you? can help to have an extra advocate when you are in situations where you aren't totally at ease.

remember, since you + baby are healthy you can always ask for more time (even overnight) to make decisions and take things at your own pace. stay calm
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#5 of 26 Old 09-08-2008, 08:42 PM
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Originally Posted by janasmama View Post
I am a huge NCB advocate and homebirther. So with this in mind:

You know your doc and the situation. I don't think that you should allow the fear of further interventions keep you from starting a necessary induction for health reasons.

I understand your fear of interventions, I have them also...but I don't think that we should let our emotions override our logical thinking.
:

My first was born at home, and last week I found out I am going to need a c-section for medical reasons. So emotionally, I have kind of BTDT and know what the internal struggle is like. Honestly what I would do in your situation is very similar to what I am doing right now in preparation for my birth: rest as much as possible, eat good food, take my vitamins, and focus on being in as good of health and spirits as possible going in to the hospital. Call in your support network and just act like you're on vacation as much as possible. Rest, relax, listen to your favorite music, buy yourself a special treat to take to the hospital (a new cd or lotion or something), and just try to keep your spirits high.

I know how scary this can be. I am scared right now too. I will be thinking of you this week!
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#6 of 26 Old 09-08-2008, 08:45 PM
 
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every time i told someone i was planning an out-of-hospital birth i prefaced it with "as long as me and the kid stay healthy"
pre-e is why we need OBs and hospitals sounds like you have a great,reasonable doc who can talk you through the possabilities. good luck and take care off yourself!!
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#7 of 26 Old 09-08-2008, 08:54 PM
 
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It sounds like you are making a good informed decision!

Also, it sounds like your body is preparing itself for labor, which decreases the chances of c-section.

The only way that *I* would feel comfortable waiting through the weekend to deliver the baby is if I had a blood pressure moniter at home, and spent the whole weekend resting, hydrating, and monitering blood pressure. If the blood pressure got out of control, or I developed a headache or other weird symptoms, I would head into the hospital.

One of my best friends went quickly from pre-e to HELLP, and after watching that situation, I know that some people stay in pre-e forever, and others need help quickly. You aren't going to know how you react because we are all so different.

My first baby was born at 38 weeks 0 days, and she did very well. We had mild trouble getting the latch down, but she was a very typical newborn.

Interventions aren't bad when they keep you healthy. Hugs and best wishes!

"Listen, are you breathing just a little and calling it a life?"~Mary Oliver

RT knitting mama  to 3 (& 8 who didn't make it) wife working on 13 years to a silly man who drives me crazy.
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#8 of 26 Old 09-08-2008, 09:01 PM
 
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All I can say is *hugs* and send you lots of : I hope everything goes well for you. No one is judging you hon... you do have a serious medical condition and we all understand that.

Rachel lady.gif, in love with my baby girl Abigailenergy.gifborn 9/17/08!
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#9 of 26 Old 09-08-2008, 09:12 PM
 
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Don't know much... however, my friend had Prepidil because she was 10 days overdue to induce labor. It did succeed in starting labor, but I guess they required that she be on her back the whole time which she said was really painful. Even though it did manage to start labor she didn't make much progress so then they started her in on the Pitocin which she said "was the devil". Still didn't make much progress. They did an ultrasound and baby was head down, but sort of tilted and not engaged at all. So then she wound up with a c-section in the end.

I hope that doesn't scare you, that's the only experience I know of with the stuff.

If I were in your position I think I'd start researching some natural/home induction methods.
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#10 of 26 Old 09-08-2008, 09:30 PM
 
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I PMed you, but..

What is your 24-hour protien in urine? What have your highest BP readings been (not the average)? Do you *feel* like you have high BP when the readings are high?

My biggest concern, once the BP started going up, was that the few times it was high, it was scary high and it was totally unpredictable. I didn't feel bad at all, but my BP was high enough a couple of times that I could have had a seizure. For that reason, I wasn't comfortable bedresting at home until 38w, which was one of the options that the doc gave us. If I'd been able to have someone with me (ie DH could have taken off or we had family in the area), that might have been different. According to my doc, the thing with pre-E is not that your average BP is high, but that you have vasospasms that cause you to have errant high BP readings, which can be as much as 4 hours apart. Those spasms are actually more dangerous because your body isn't used to dealing with high blood pressure like that and that increases the risk of your placenta abrupting or you having a seizure or stroke.

Okay, so that's the scary stuff. The not-so-scary stuff is that you have a doc who is on top of it and is willing to go slowly with your induction. I'd go tonight and get some EPO capsules and do 3 caps vaginally every 6-8 hours until about 6 hours before the cervadil is started, then if you go through the weekend, continue to do the EPO (and maybe have lots of sex) then. You might also ask your doc about doing a foley induction (search in the Birth Professionals forum for more info on this). The idea here is that if you can get to a 3 or 4 before the pitocin induction is started, you'll have a much better chance of a successful induction that doesn't end in a c-section. And if you do end up opting for an epidural (because pit contractions can be hard and because being on pit limits your range of motion--via IVs and monitors-- and therefore your coping ability), try your darnedest to get to 5 or 6cm before you go for it. It's possible that your BP will only be acceptable on your side, which might make for a really misearble labor. In this case also, think epidural because it will have a side effect of lowering your BP. And yes...do you have a doula or a friend with NCB experience to attend your birth? Because this is likely to be pretty overwhelming for even the most supportive DH (mine included...and I'd say he was supportive of NCB to a fault ).

Charlotte, midwife to some awesome women, wife to Jason, and no longer a mama to all boys S reading.gif('01), A nut.gif ('03) S lol.gif ('08) and L love.gif ('10).
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#11 of 26 Old 09-08-2008, 09:33 PM
 
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but I guess they required that she be on her back the whole time which she said was really painful
Yes, I forgot that part...they did require me to be laying down for 2 hours after inserting the cervadil. It's more of a gravity thing than anything else...they need it to stay in contact with your cervix. I don't know if the 2 hours was just for me (we only did 4 hours of cervadil before moving on, but the usual dose is 6 hours), or if that's the standard. I can see that if they started pit at the same time or if the cervadil started labor, that could be a pretty miserable couple of hours. For me, I needed to pee right after they inserted it. By the time 2 hours was up, I had to pee so badly I wanted to cry (but not badly enough to use a bedpan ).

Charlotte, midwife to some awesome women, wife to Jason, and no longer a mama to all boys S reading.gif('01), A nut.gif ('03) S lol.gif ('08) and L love.gif ('10).
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#12 of 26 Old 09-08-2008, 10:00 PM
 
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how do you feel about trying EPO? Or other "induction" methods (ie nipple stim, acupuncture, castor oil)? I think that if I were in your shoes, I'd try some of the other things- even if they don't put you into labor, they might help get the conditions a little more favorable for a medical induction.

that said, mama. it's not easy to deal with this stuff at an already emotional time.

modern-mama to DS (5.16.05) and DD (9.11.08) and one more (GIRL!) coming in December
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#13 of 26 Old 09-08-2008, 11:28 PM
 
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In your situation, I'd say that an induction is warranted. You can, however, do things to make it more favorable and less likely to end in c/s. Start taking EPO immediately, at least 1000mg by mouth and 1000mg inserted vaginally, to help ripen your cervix. If you can, also have sex. The fact that you are not closed shut should hopefully help your case a bit. Rest as much as possible, and mentally prepare yourself for any scenario, just in case. It's normal to be scared, this is a scary situation. But it sounds like this may be the best option health-wise for you (and in turn, the baby).

Mom to DD#1 8/04, nursed 43 months, DD#2 8/06, nursed 21 months and DD#3 9/08, still nursing strong
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#14 of 26 Old 09-08-2008, 11:36 PM
 
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Oh Kati I am so sorry that you have to go through this! I don't have any advice but I just wanted to send you some love and support. I can imagine that you must be overwhelmed and scared. You and Poppy will be in my heart and thoughts. Trust your own instincts mama. Whatever your birth ends up being like you will have a beautiful Poppy in your arms soon.

AP crunchy homeschooling mama to Henning (1/4/03), Connor (7/1/05) and Elijah (9/21/08) Forever holding my 3 lost little ones in my heart.
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#15 of 26 Old 09-09-2008, 12:36 AM - Thread Starter
 
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Thanks so much mamas! It meas a lot to me to see all the positive words and support.

I am taking a LOT and I mean like 4000mg of EPO orally, but haven't done it vaginally. I'll start that tomorrow. I also have a wonderful doula - and I know that's going to be invaluable. We've also been having sex almost every night for the past two weeks

We've made lists of all the little last minute things to do and get done so hopefully that will help keep me busy and keep me from stressing too much in the meantime.

So I'm just trying to get my mind ready - my heart has been ready for this for a much longer time!

kati , wife to josh , mama to j&d (7.31.07) marion (9.18.08), feeder of nanuq and gracie lou
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#16 of 26 Old 09-09-2008, 12:57 AM
 
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((Hugs)), Kati. it's definitely a good thing that we have the ability to detect and deal with serious issues that arise during pregnancy. I wish you lots of luck. Take good care of yourself! * Jaime
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#17 of 26 Old 09-09-2008, 02:24 AM
 
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#18 of 26 Old 09-09-2008, 02:37 AM
 
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Originally Posted by alyssatuininga View Post
Oh Kati I am so sorry that you have to go through this! I don't have any advice but I just wanted to send you some love and support. I can imagine that you must be overwhelmed and scared. You and Poppy will be in my heart and thoughts. Trust your own instincts mama. Whatever your birth ends up being like you will have a beautiful Poppy in your arms soon.
I feel the same way as Alyssa! I don't have any advice but wanted to let you know I'm thinking of you and feel confident you will make out great with your DD in your arms soon!

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#19 of 26 Old 09-09-2008, 10:21 AM
 
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My SIL had pre-e with both of her kids and was induced for both - a far cry from her hope of a home birth with her first. BUT - she was cared for and her health and that of her babies' were protected, and she has two beautiful, healthy kids.

The biggest thing I can say is prepare yourself to be ready to do what you need to do for your own health and that of your babe's...having a peaceful, positive mindset about come-what-may, even if it's the farthest thing from your dreams, can help make everything go more smoothly. Be prepared to work with your body, make sure your DP is well-prepped to be your advocate if needed so that you can focus on what you need to do. It sounds like you have a doc that you trust, and hopefully that translates to a birth team that you trust. If you don't have a doula, that may help no matter what ends up happening...

I spent a lot of time in the month prior meditating in a not-at-all-organized fashion on preparing my mind and releasing fear about the possibilities - it made a big difference.

Good luck, JG!
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#20 of 26 Old 09-09-2008, 11:35 AM
 
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Sorry this is happening to you!

My mw suggested 2 TS of castor oil mixed with orange juice and champaign to try to induce at home....
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#21 of 26 Old 09-09-2008, 11:45 AM
 
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I have no practical advice but wanted to offer you big hugs. I hope you can get to a place where your birth is still an amazing, positive experience.
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#22 of 26 Old 09-09-2008, 11:49 AM - Thread Starter
 
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Thanks mamas - we laughed at ourselves last night - 9:00 p.m. found us out at Target running around to get the last few BFing supplies we needed and a "just in case" paci and such. I also ordered the last of my cloth dipes yesterday and told the seller, please rush as she may be here this weekend! It was quite a comedy - but we needed to laugh.

I'm going to spend today quietly at the house getting things in order and preparing my mind with some meditation and some breathing. Tomorrow I have my first LLL meeting and lunch with my girlfriends then dinner with a group of other expecting mamas, so I'm just going to soak up all those positive vibes and take them with me on Thursday morning.

Watch it - all this preparation and freaking out we're doing, and she still probably won't come until her EDD - silly, stubborn girl we have on our hands

kati , wife to josh , mama to j&d (7.31.07) marion (9.18.08), feeder of nanuq and gracie lou
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#23 of 26 Old 09-09-2008, 03:03 PM
 
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Hi Kati, I'm so sorry that you're going through this after everything you've already been through to get here.

I would try bathing in epsom salts to allow your blood pressure to drop slightly- if it works, great, if it doesn't then what the heck. That's one of the few things you haven't mentioned trying yet. I'd also get very very in-depth and personal with your doctor- what's the VBAC climate like over there? If it's not great, you really need to get this baby out of your yazoo by whatever means.
Some things you need to know: epidurals lower blood pressure. This is one of those circumstances where I am saying, with total blinding seriousness, take the drugs.
The ladder of interventions put you at greater risk of infection, one way or another, because you may end up with a c-section or episiotomy. Start yourself on vitamin C and zinc now to get your immune system at top-notch now- thinking about it, actually, I'd take probiotics as well.
If your membranes remain intact, the induction can be stopped at any time. Once they have been artificially broken, Poppy really needs to be out of there within 18 hours, one way or another.
On breastfeeding: Poppy is likely to maybe need a little more help to get the hang of it than she would have done if she'd cooked till 42 weeks. Don't take the pacifier, you don't need it and it could set up problems later on. Get her to your chest immediately, don't allow routine separation for observation, and keep her close and feed her lots. No supplements by mouth, especially not formula in a bottle. You ideally need a side-car bassinet for your hospital bed to keep her close whilst letting you get some sleep.
Finally, I'd read Birthing From Within. It helped me a lot this time round, and it helped ease me into a gentler frame of mind. I know people have found it helped them let go and accept that birth is a miracle, regardless of how it unfolds and who you accept intervention from

Oh, on natural inductions: there isn't anything other than acupuncture or homoeopathy that I would consider safe enough for someone whose blood pressure is high enough to require medication, and you need professionals for both of those. I did do ginger compresses that last week with River, though, and it felt good (fresh ginger steeped in boiling water then placed straight on my bump.) Castor oil is horrible and the cohoshes weren't much better, plus didn't actually get the baby out. My vote is take the pitocin and the epidural.

Helen mum to five and mistress of mess and mayhem, making merry and mischief til the sun goes down.
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#24 of 26 Old 09-09-2008, 05:18 PM
 
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I agree about the pacifier, ideally the baby should not have anything except your breast before at least 1-2 months old, or you run the risk of nipple confusion. You do start to feel like a human pacifier in the early days, but that helps establish your milk supply.

Mom to DD#1 8/04, nursed 43 months, DD#2 8/06, nursed 21 months and DD#3 9/08, still nursing strong
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#25 of 26 Old 09-09-2008, 08:31 PM
 
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First of all, big to you.

Sound like you have some good advice and still some options, AND a good support network.

The one thing I have to add is take time to meditate/pray/walk/yoga...whatever YOU need to do to get centered mentally, emotionally, spiritually.

Fear is not the most effective place from which to make decisions. Trust yourself and trust the universe. Find some peace and KNOW that everything will be just as it is supposed to be...
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#26 of 26 Old 09-10-2008, 12:13 AM - Thread Starter
 
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Thanks again mamas - I spent today doing some nesting and now, I can honestly say all I feel is joy and excitement at the prospect of meeting her. There are moments of some fear - but I have some special songs just for her that I played over and over today as I was around the house and I just wouldn't let myself dwell on the negative.

She was so well behaved today - lots of movement to keep me from worrying and I had some more BH/possible contractions so I'm just trusting that my body is going to do it's thing and it's capable of handling this.

Thanks again and everyone can expect a play by play on Thursday - thank heavens for wireless at the hospital!

kati , wife to josh , mama to j&d (7.31.07) marion (9.18.08), feeder of nanuq and gracie lou
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