False Alarms

Another of the expectations of pregnancy which have been fostered by movies and television is the idea of the False Alarm. As portrayed, the False Alarm always consists of the pregnant woman waking her husband up at three o'clock in the morning saying, ``It's time!'' whereupon the two of them dash to the hospital amid madcap humor. Of course, it turns out to be a False Alarm--the baby isn't coming yet--and the weary husband and sheepish wife return to bed. This has to happen at least three times. Then, when it is least expected, the woman's water breaks, and she is rushed to the hospital for the five minutes it takes to deliver the baby.
  Once again we as a culture have been lied to. In fact, most births are not signaled by the water breaking. Usually, the water breaks well into labor, which is good because they pay people to mop up big spills in the hospital. At home you just get to do it yourself and no one pays you. And sometimes, the water doesn't break at all, although most doctors won't let a woman deliver a baby without breaking her water for her if it doesn't happen on its own. But babies do get delivered with the amniotic sac intact, and it doesn't hurt anybody--except film producers, who scream ``Cut!'' and demand to run the shot again.
  In addition to this little falsehood, we were lied to about the False Alarms. I imagine that some people somewhere have False Alarms just like they do in the movies--maybe the very first time a False Alarm was filmed, the scene had been written by someone who had experienced exactly that, after which the idea of the False Alarm passed into film culture and was repeated endlessly. But our False Alarms were nothing like that.

Our first False Alarm happened while Dawn was at work, about three weeks before the due date. I was working from home that day. She called me.
  ``I think my water broke,'' she told me.
  ``What makes you think that?'' I asked, always the height of cool.
  ``I just went to the bathroom,'' she explained, ``and the water kept coming out of me and I couldn't stop it.'' This was how we were taught to tell when your water breaks in the Bradley class: if it feels like you're urinating, but tightening the Kegel muscle doesn't stop the flow. Of course, if you're just standing there and find yourself suddenly knee-deep in amniotic fluid, that's a good clue too.
  ``That sounds like your water broke,'' I said helpfully. ``I guess you should come home.''
  It was then that I realized how woefully unprepared we were for the birth at that exact moment. We didn't have a bag packed. We didn't even have most of the stuff we would want to pack in a bag. We didn't have the crib up at the time, or the changing table or anything. We didn't have any baby's clothes washed and ready to wear. We were hopelessly off-guard. And I think that's why people have False Alarms--they're nature's way of making you realize you didn't take this seriously enough. A False Alarm is a whap upside the head saying, ``Get with the program, bozo!''
  I went to pick up Dawn at the train station and rather stupidly went to the wrong station. Sometimes I pick her up there, but we had specifically decided it would be better and faster to have her go to the closer station. I knew this and very deliberately went entirely the wrong way.
  When I finally did pick her up, I tried to explain that it wasn't nervousness that made me slip, but just pure stupidity. I don't think she bought it. But I really didn't feel nervous.
  Dawn had called the doctor, and since they had office hours during the day, Doctor Number Two suggested that Dawn come in to the office first. After all, if her water did indeed break and she was indeed in labor, we had some time before anything really momentous was going to happen. Probably. And anyway, the doctors' office was only a block away from the hospital.
  Also, Dawn wasn't feeling any contractions. Like it is possible to be in labor without breaking your water, it's also possible to have broken your water and yet not be in labor. In general, it seems that doctors will let you go for about twelve hours with a ruptured amniotic sac and no labor before they induce labor; apparently, they feel that the loss of the protective sac opens up the baby to a greater risk of infection and they don't want to leave them open for too long. What the baby is going to do for protection when they get out, I don't know, but this is the doctors' reasoning.
  After my slight course change we went home and packed a makeshift bag just in case. Then we went to the doctors' office, where we were, of course, seen immediately.
  Doctor Number Two was excited for us, naturally, and happily performed the first test to see if there is amniotic fluid in the vagina. Dawn was put up on the table with her feet up in stirrups and the doctor used that device with the crank on it to open her up. Then the doctor took a ribbon of special paper and, using a pair of barbecue tongs, dipped the paper in my wife's innards. The paper turned bright green.
  ``That's a good sign,'' our doctor told us. ``Now we want to do one more test. By the way, you're two centimeters dilated.'' While she had Dawn up in the stirrups and cranked open like a car window at a toll booth, she took a small sample of the fluid from, I guess, near Dawn's cervix. Then the doctor left to perform the second test while Dawn got her window rolled up again.
  Dawn was excited. I was curious. I looked at the little jar of paper from which the doctor had gotten the piece for the first test.
  ``It's litmus paper,'' I told Dawn. High school chemistry lab had come in handy after all.
  ``What?'' Dawn asked me.
  ``It's just plain old litmus paper,'' I marveled. Sometimes I think anyone can be a doctor. The jar even had a little color scale on the side in case the color green wasn't obvious enough.
  ``We're going to have a baby,'' Dawn said.
  ``No kidding,'' I replied.
  Our doctor returned. ``We have a slight problem,'' she began. ``You see, the first test--the paper--says your water broke. The second test--where I look at the fluid under a microscope--says it didn't. So now we have to do a third test. Come on over to the ultrasound room and we'll check you out.''
  Again, the Bradley class came in handy. We had been told that sometimes, the amniotic sac springs a small leak. This can make it seem like your water might have broken. Then the leak gets sealed up again, in some unspecified manner--maybe the baby presses their finger against it like the boy with his finger in the dike--and it turns out what you have is a False Alarm.
  What the doctor wanted to do with the ultrasound was see if the baby was moving and also check to see if there was still a lot of amniotic fluid surrounding the baby. If there's still a lot of fluid, then it was just a small leak and therefore a False Alarm.
  So we got to visit with the ultrasound woman again. This time, though, the doctor referred to her as a sonographer. If only I had heard the term earlier, this book would have been a lot easier to write. I felt really bad calling her ``the ultrasound woman'' for page after page, but I didn't know what else to call her. Sonographer. Much better, much more professional sounding.
  In any case, we got to visit with her again. She performed her usual magic with the cold goop and the handset. While she was there, she checked on the baby's measurements. She also got us a good shot of the baby's genitalia. From what I saw, the baby was either a boy or a girl with a serious swelling problem.
  From what she could see using the magic ultrasound machine, the sonographer determined that there was still plenty of fluid and that the baby was doing fine. She also made an estimate of his weight. She estimated that the baby was about 7 pounds 10 ounces.
  ``You want to get this baby out soon,'' she said. ``He's getting big in there. Come on, hurry it up.'' She spoke to the baby through Dawn's belly. ``Come on out, big guy,'' she said.
  But everything looked fine in there, so we went home to wait some more.

Next we hit the Twilight Zone of pregnancy: two weeks before the due date. Two weeks and one day before the due date, everything was just like it was for the previous eight and a half months--an inactive waiting. Two weeks before the due date and the doctors started furrowing their brows at us as they looked over our chart. I started jumping at the slightest twinge from the direction of the baby and I wasn't even attached. Everyone started wondering, Where is the baby?
  Then we reached our due date in the middle of the Twilight Zone and our doctors wanted us to come in every few days to make sure everything was going okay. Half of the visits they asked for biophysical profiles, where the sonographer scans the baby and measures them and checks the amniotic fluid and the heartbeat and comes up with a weight estimate. The other half of the visits the doctor performed an internal exam to see how Dawn's cervix was doing, what it was up to, how it was enjoying the weather, and so forth. Luckily, the initial price we paid to the doctors covered however many visits we made, because we were at the doctors' office nearly every other day. We thought about getting an apartment in the same building as the doctors' just to save the commuting time.
  The baby continued to thrive and Dawn's cervix continued to ripen--which always struck me as too fruity a metaphor, like Dawn's cervix was sitting on a kitchen counter until it was ready to eat. Contractions continued to not happen. We were beginning to eat, sleep, and even breathe doctor's visits.
  Another type of test they did during these visits was what is called a non-stress test. The doctors do this to make sure the baby isn't under stress. What they did was this: They strapped a fetal monitor on Dawn which registered the baby's heartbeat and the contractions of Dawn's uterus. Then they gave Dawn a little game show button to press every time she felt the baby move. The idea is that the baby's heartbeat should go up a little just before they move, and also that their heartbeat should not go down during contractions.
  This test takes a while. A long while. Dawn laid on that examining table for about an hour and a half while I paced and listened to the baby's heartbeat, helpfully made audible by the monitor. Every so often a nurse would come in, look at the long strip of paper being spewed out of the front of the monitor, and maybe give Dawn's stomach a poke to wake the baby up.
  Our baby and Dawn passed all these tests with ease and grace. If there was an Olympic event for non-stress tests, they would have returned with the gold.
  A few days after the due date, the biophysical profile estimate for the baby's weight was up to 8 pounds 13 ounces. Dawn's cervix was still slightly dilated and was in addition 60 percent effaced, meaning that it was thinning out while it dilated for the birth. So clearly the pregnancy was progressing, but no contractions were forthcoming. The baby was apparently comfortable in there.

Our next False Alarm happened after dinner. We went out to a chain restaurant and Dawn had some pretty spicy food. By the time we got home that night, she said she was feeling contractions fairly regularly. We went for a walk, because walking helps to speed labor in the early stages.
  We walked around our neighborhood for a couple of hours. Dawn continued to have contractions as we did so. It was a beautiful night, cool and dry, one of those scant few days of true New Jersey spring. We walked and we talked, slightly giddy and expectant, a sort of full-circle to the night the baby had been conceived. Every so often, a contraction would stop Dawn right where she was standing, almost in mid-step.
  Then we began to get tired and it began to get late, so we wound our way back home and went to bed, fully expecting that we would be in the hospital that night in full labor.
  It didn't happen. The contractions stopped almost before we got home and didn't start up again. The baby wasn't yet ready.

On May sixth, almost a week past our due date of April thirtieth, we went in for another non-stress test. Dawn and the baby again passed beautifully and stylishly.
  We then met with Doctor Number One.
  ``I'd like to induce you,'' she said to Dawn. ``According to your last biophysical profile, the baby is almost nine pounds. I'm afraid if we wait much longer, this baby's going to be too big for you to have without a cesarean.''
  All along, I'd been telling Dawn she'd have no problem having this baby. Her mother's first labor, after all, was only three hours. And her mother's third baby--my brother-in-law Eric--was born at nine pounds after two hours of labor. My wife and her mother both have these incredibly wide hips--child bearing hips if there ever were--and I kept telling Dawn she'd fire this kid out like a grape. I told her they'd have to wipe our baby off the wall after she was done. I even suggested getting a cork to keep the baby in there for the last couple of weeks--we wouldn't want her accidentally firing them out early.
  So I scoffed at the doctor--inwardly. Outwardly, I asked her if these sonogram estimates were accurate.
  ``They're very accurate,'' she assured me.
  Dawn and I talked it over and decided that we really didn't want to get induced yet. The baby had at least another week to go before we thought it was necessary. We told the doctor as much.
  She appeared to think that waiting was my idea, and that if Dawn had her way we'd be inducing. Which is not quite the truth. I was certainly more adamant against inducing than Dawn was, but neither of us really wanted to go that way unless we felt sure it was necessary. At this point, we didn't feel sure.
  ``Okay, we'll wait,'' the doctor said, and scheduled Dawn for another biophysical profile on Friday, May ninth. And we went home again.

Our next False Alarm was not a good one. Dawn called me into the bathroom.
  ``I'm bleeding,'' she said.
  A quick check showed me that she had some blood and some mucous, which could be her mucous plug. This was something else we learned at Bradley, although I guess one can learn about this lots of places. The mucous plug is, well, a plug of mucous that stops up the cervix during pregnancy. Towards the end of the pregnancy, it can come out. Sometimes it doesn't, and sometimes when it does it goes unnoticed, and sometimes the woman finds it. Sometimes it looks like a plug and sometimes it doesn't, and sometimes it has blood in it and sometimes it doesn't. In short, it is yet another one of those things that can be pretty much anything and everything all at once.
  Well, there we went again, just in case. We called the doctor and went off to the hospital. Once there, Dawn was again strapped into the fetal monitors in bed. By that time she had stopped bleeding. The nurse on duty performed an internal exam and determined that Dawn's cervix was about three centimeters dilated. The nurse's glove came out clean.
  Doctor Number Four was working the hospital that night and he came in to see us.
  ``I think you should spend the night,'' he said, ``And we'll induce you in the morning.''
  I didn't think so at all. We had only just reached our due date, after all. I couldn't understand this. Here we have a date which is basically pulled out of the air. It is based on approximations of estimations of possibilities, all piled on top of one another until the final number is hopelessly inaccurate. We have measuring errors in the sonogram, operator error with the machine, operator error with the bodies involved in the conception, and calibration errors. We have statistical deviations from the norms used as baselines for the equations that determine due dates. We have statistical deviations of babies and when they're ready to come out. Into this mess we can throw doctors' prejudices and preferences, as well as medical science's conservativism and dogmatism. And when we're done with all of this, we get a number, and for some reason someone thinks this number should be taken seriously.
  Well, I didn't think so. And I tried to tell our doctor as much, only I tried to couch it in nicer terms and only take the points one at a time.
  He stood his ground. ``You've held to the due date perfectly,'' he noted. ``These sonograms are very accurate. According to this, your baby is almost nine pounds. I want to get the baby out before he gets too big. You're in here with bleeding now, you're already at three sontimeters....'' He trailed off meaningfully. I wondered how an American could, with a straight face, pronounce ``centimeters'' as ``sontimeters''.
  And I pretty much felt that we had no idea how big the baby was. ``I understand these ultrasound measurements have an accuracy of ten percent. This baby could be smaller than eight pounds.''
  ``And he could be over ten,'' the doctor said. ``Look,'' he said to Dawn, ``If you were my daughter, I'd have you stay the night and get induced tomorrow. I can't make you, of course, but I think it's best. Think about it.'' With that, he left the room.
  Dawn and I were just about to talk it over--even though we were both almost entirely sure we wanted to wait--when the doctor burst back into the room waving our chart furiously.
  ``What did you say your due date was?'' he demanded.
  ``April thirtieth,'' Dawn answered.
  ``That's wrong,'' he declared, and shuffled through our papers. ``See here, back in October, it has your date down as May seventh, by ultrasound. Then, in November--May seventh again. How did anyone get April thirtieth?''
  ``Well,'' Dawn explained, ``That was our first due date, and when the ultrasound changed the date, the other doctor said that since it was within two weeks of the previous date, we should just keep the old one--April thirtieth.''
  The doctor pulled out the little plastic Wheel of Pregnancy that obstetricians carry around for calculating due dates. He spun the wheels angrily. ``I get May seventh,'' he said, and with exasperation crossed out the due date of April thirtieth on our chart and wrote in May seventh.
  ``Okay, you can go home,'' he said cheerily. ``You're not due for a few days. Never mind. You can go home if you want to, no problem. But I want you in as soon as possible for another biophysical profile. Come in to the office tomorrow.''
  ``Do you see how arbitrary this due date is?'' I complained to Dawn. ``One minute, the baby has to come out now, the next minute, it's okay to go home. Flip a few numbers around and you go from unhealthy to healthy, from risky to risk-free. Why does anyone take this number so seriously?''
  We went home.

The next day, May seventh, we went in for another biophysical profile. The sonographer was surprised to see us again.
  ``Is this baby ever coming out?'' she wanted to know.
  ``He's comfortable in there,'' I ventured.
  ``Well, he can't stay in much longer,'' she said. ``He's getting huge.''
  This time the weight estimate was 9 pounds 5 ounces. Doctor Number Two did an internal exam, also, and found Dawn was 3 centimeters dilated and 80 percent effaced.
  ``I think we should induce you before the weekend,'' the doctor suggested. ``Your cervix is ready. This baby is big. I think we need to induce and get him out of there.''
  ``Well,'' I said, ``Aren't there other things that need to happen, besides the cervix ripening, for the baby to be ready to come out? We don't know what needs to happen.''
  ``Nope,'' she told us. ``If the cervix is ready, the baby is ready. The baby's been ready. For a couple of weeks everything that the baby needed done has been done. I think we should induce.''
  ``What about the change in due date?'' Dawn wanted to know.
  ``Well, even by that date, the baby's due. And he's certainly big enough.''
  Again, Dawn and I talked it over and Dawn asked some more questions and I asked some more questions, but basically the doctor wanted to induce Friday.
  ``Can we wait until, say, Monday?'' I asked. ``Monday will be two weeks past our original due date, and I figured we'd be inducing by then anyway. So what say we do it Monday, would that matter?''
  ``It wouldn't make much of a difference,'' the doctor replied. ``If you want to wait, you can. But you might as well get it done sooner.''
  I felt that it did make a difference. I wanted to give the baby as long as possible to come out on his own. I was looking to buy him a little more time to get done whatever he needed to get done.
  ``Look,'' she suggested, ``Why don't you go home and decide if you want to go Monday or Friday and call us to set it up.''
  As we were leaving the office, Dawn tried to find out which of our four doctors would be working at the hospital Friday and Monday. Friday, she was told, it would be Doctor Number Two, but they weren't sure who was on Monday.
  We went home, and Dawn decided she was more comfortable knowing who her doctor would be. She decided she was ready to get induced Friday. So Thursday morning, May eighth, Dawn called the hospital to see about scheduling an induction for Friday, May ninth.
  Then we got what I thought was a sign. But it's hard to tell these things. In the movies, everyone can always tell it's a sign. In the Bible, everyone can always tell it's a sign. But in real life, who can tell? In the movies, you've got the music. When there's a sign happening, there's this big music thing that happens too, so everyone can be sure it's a sign. In the movie L.A. Story, when the big storm comes keeping Victoria Tennant from taking the plane back home and she and her tuba return to Steve Martin, there's this mystical Enya musical swell in the soundtrack, and we know that the storm is a sign.
  And in the Bible, when Samuel talks to Saul, no one questions if it's God speaking. Moses had a burning bush. Daniel tells David he's behaving badly, and David knows God is a little miffed. Everyone knows when it's a sign because, after all, we're in the Bible. What else could it be but God talking?
  But in real life, things are not so simple. No one's gotten the soundtrack working in my life and the only fires I've witnessed were generally started by me or someone standing nearby. Except in Boy Scouts, when we had something of a reverse sign in the form of no fire, which I took to mean, Go home and have Mom cook something.
  Anyway, we called the hospital the day before we decided to be induced. And the doctor told us that, while the schedule had been clear the day before, suddenly they had three inductions, three cesarean sections, four something elses, and post-partum was full already. In other words, there was no room at the inn.
  I decided to take this as something of a sign, just in case. I decided this was the universe's way of telling us that the baby should come on his own. But I thought maybe the baby needed a little help.
  So I took Dawn out to the same restaurant as before, although this time for lunch, and had her eat all the same foods as before. As we left the restaurant she began to have contractions--it was working. We got home and went out for another walk, this one through the fine spring day. She continued to have contractions as we walked, just as before. We began to feel thrilled and expectant again.
  And, just as before, by the time we got home from our walk the contractions had stopped. Maybe it was just gas.
  I went to bed that night disappointed but also relieved, thinking that we had done what we could and the baby now had his chance to come on his own over the weekend. My dad's birthday was Saturday, too--so maybe the baby was just waiting to be born on his grandfather's birthday. Wouldn't that be nice? I drifted off to sleep thinking of how happy that would make my dad.
Index |  Next