On Thursday we went to the OB for a biophysical profile (this checks baby's movement, amount of amniotic fluid, and general health) and a routine visit. That's not what happened.
The good news: the baby is 100% healthy and awesome. The biophysical came back with the highest score possible. Yay!
The bad news: according to the ultrasound, I am carrying a nearly 9 lb baby. When you factor in the margin of error, he could be a little below 8 lbs. Either way, big baby. The accuracy of an ultrasound isn't great, but the smaller and slimmer the mother, the more likely it is to be right...balls!
On to the doctor's visit. Let me preface by saying that I am seen at a practice with three physicians and we choose to rotate through them because any one of them could be on call when the baby is born. That said, the doctor we were seeing on Thursday is my least favorite. His bedside manner is fantastic, but his scope of knowledge leaves me...unsettled. He's one of those go by his guts type of guys and his response to items on my birth plan (which is short and simple) weren't very reassuring. For instance, while the other two doctors both were fine with my request to avoid an episiotomy unless it looked like I was going to tear toward the front, this doctor went into how this was "an art" and he would basically make the decision to do an episiotomy or not to avoid "my bottom blowing out."
So, still reeling from being told I am having a mammoth-sized baby, the doctor comes in, looks over the biophysical report, "um, looks good, very healthy...8 lbs. 14 oz. So, what do you want to do?"
I request that he conduct the internal exam before we start discussing options (if I'm dilated to a 3, that's going to influence my decision). Instead, he launches straight into a soliloquy about potential complications related to the baby's size - permanent nerve damage to the shoulder, distress, death. That's right, he went there. Right away. So, what do I want to do?
Again, I say I'd like to have him conduct the internal exam. Obviously a bit annoyed, he gets the nurse, does a very quick exam and says I'm not dilated at all. R and I share a look. R asks, "So it can go backwards?" Because I was at 1.5 cm the week before. The physician basically blows this question off and starts talking about induction. He makes it clear that it would be a multi-day process and because I'm not dilated, he thinks it would end with a cesarian. Then he goes back to talking about babies dying!
When I try to ask him a question, he cuts me off and tells me how he'd do an induction. It involves the drug that we learned about in my birthing class. The one known to have the most risks of hyper-uterine stimulation. That means uber painful for me, most likely to stress the baby, and most likely to lead to a cesarian. R asks him if that drug is even FDA approved (we know it isn't), and he says "not that I know of." Then he rationalizes why he uses it anyway. Grrreeeaaat.
To sum up, when I said I really want to avoid a cesarian he tells me that "I wouldn't put money on it if I was a betting man." Repeatedly warns me that the baby is only getting bigger while I wait. Implies I should go straight to a cesarian to avoid distressing the baby. And then starts telling me of the advantages of a cesarian, totally glossing over the fact that this is major surgery with all the potential risks of any other major surgery, like hemorrhaging and infection.
Needless to say, I was feeling backed into a corner. Which starts to make me mad. I'm not avoidant when it comes to arguing the facts. I have extensive training in doing so, that's basically what graduate school is. But I don't want to piss off the guy who might be delivering my baby. So instead of attacking his talking points, I point out that the confidence interval (level of accuracy) on the ultrasounds when it comes to size estimates are really poor. This causes him to back pedal. He admits that their practice never recommends interventions due to the baby's size.
I'm left thinking then why are we having this whole conversation?? My baby is perfectly healthy. I'm not pushing to get him out early (though I'd love it if he'd come). And I was only 4 or 5 days overdue, depending on what due date you want to use. On average, babies come over a week after their due dates. The range for full term is 38-42 weeks. They use 40 weeks because it's in the middle. He knows this, so what's with all the pressure?
In the end, we agree that I schedule an OB appointment for Monday (tomorrow) and I think about it. And, I have thought about it. And the more I've thought about it, the more pissed off I am! F this guy! He's the doc on call this weekend, and as much as I want this baby out, I spent the whole weekend whispering to my bulging belly, begging our little guy to wait until Monday.
Unless there is a reason, based on the actual health and safety of my baby (P.S. size isn't a recognized concern by the American Congress of Obstetricians and Gynecologists because pelvises expand and babies squish), this baby is staying in there until he wants to come out. On his own.