At my appointment a week ago, my OB asked if I'd given any thought as to how I'd like to birth this baby and the fact is that I'm just not sure at this point in time. Thanks to the way Kaiser staffs OBs in their hospitals, he doesn't have any vested interest in pushing either method of delivery (surgical or vaginal) and I truly get the impression that it doesn't make a difference to him one way or another. The only thing that he had a definite opinion on is that he asked that I decide how I'd like to birth this baby by the 7th month or so and I'm hoping that I'll have an answer by then.
I hate feeling this way, but I fear that my body won't do what it's supposed to do if I choose to have a VBAC. I feel like my body has already failed me in terms of pushing out a fetus so I have zero confidence in my ability to vaginally birth a baby being born at term. I know myself well enough to realize that I will feel like a personal failure if I go for the VBAC and still end up with a c/s and the last thing a hormonal new mother needs to feel like is a failure.
On the other hand, I felt like I was hit by a freaking bus after my c/s. I really don't relish the thought of such a painful recovery while caring for a newborn and my son. I also would like to spend as little time in the hospital as possible and I'm pretty much committing to three-days if I go the c/s route.
Adding another wrinkle to my decision making process is that I'd prefer to have my doctor do the honors if I have to have someone slice open my abdomen. I know it sounds kooky and I'm sure the other OBs on staff are perfectly competent, but I have absolute confidence in my doctor's competence and I don't want some stranger to cut me. Going back to the way Kaiser staffs their OBs at the hospital, the only way I can be sure that my own doctor will be the one rifling around in my insides will be if I schedule the c/s. Well, that and it would be important to know if he'll be scheduled to work in the hospital at some point when I'm at term.
At the moment I'm leaning toward having an elective repeat c-section and it's only the weeks of pain that I know I'll experience if I go that route that is keeping me from outright saying that my baby will be cut from me rather than naturally released. I feel so emotionally scarred from my failed natural miscarriage that I don't think a VBAC is right for me under any circumstances. I can't even visualize a VBAC without thinking about that painfully heartbreaking day and I'd hate to cloud this baby's birth-day with memories of such sadness. Of course, my thoughts may be totally different on another day so my decision is far from being made.
Did you have a c/s and end up having another child afterward? What did you choose? Why? What was your outcome? Thoughts, advice, and opinions are welcome and I only ask that all comments are kind and respectful.
Showing posts with label VBAC. Show all posts
Showing posts with label VBAC. Show all posts
Friday, August 5, 2011
Monday, January 31, 2011
Opinions Are Subject to Change
I have very definite opinions about many topics, but I think you'll agree that very few things make me spout my viewpoint as readily as parenthood. You all know that I'm a little bit of a hippy as it relates to pregnancy, childbirth, and child raising. I think it's important to remain solid in your position, but I believe it's smart to change opinions as new information emerges. Personal experiences and anecdotes also tend to help sway opinions. After my recent miscarriage experience and the resulting hospital visit, I've had a 180 degree change of heart on two things:
1. I will never, never, never take the "wait & see" approach should I experience another miscarriage.
2. Screw VBAC, I most definitely want a CBAC should I experience another full-term pregnancy.
What was so bad about taking the wait & see approach to this miscarriage? I have found that the emotional cost was too high to ever choose expectant management (the technical term for wait & see) again. Based on the physical experience itself, I'm not sure that it was possible for me to go the all-natural route. It certainly was not happening this time around and I have been scared away from ever considering it again. Yes, the D&C sucks, but I think it was lame to go through all the suffering beforehand only to have to have a D&C anyway. I'm fairly certain that is why I've found this recovery to be a little more difficult than I expected.
I do, however, feel that expectant management would have been perfectly fine had I not been as far along as I was because very early (like way the heck early) miscarriage is a lot like a heavy period. A somewhat chunky and heavy period. So it's both gross and sad.
I have written several blog posts on why a drug-free vaginal birth is my personal holy grail of childbirth so I'm sure it's surprising that I'm more than willing to voluntarily ask for a c-section if I ever give birth again. Not just more than willing, I mean I will outright say that I will absolutely get sectioned and I'm not willing to have a trial of labor. I just will not do it.
Why did this event cause me to change my mind about my next childbirth experience? Because my cervix WOULD NOT DILATE even though I HAD TO PUSH. This has me totally mystified. I feel like my body somehow betrayed me because the urge to push was undeniable and totally unstoppable and the pushing was really for no purpose because my cervix wasn't anywhere near to being ready.
I didn't just want to push, it seriously was all that I could do at a certain point during this ordeal. Pain and pushing, pushing and pain; that's what stands out in my head about last Wednesday. I tried a few positions to get things moving on out and had no luck; I straddled the toilet, I did an odd kneel/squat beside the toilet (when I was still vomiting), I sat on the toilet with my feet on a step stool and my knees drawn up & spread wide. I pushed and pushed and pushed. Nothing happened!
I was PUSHING with everything I had, but nothing happened because my cervix was still pointing in the wrong direction and still would not dilate! I could have pushed for hours longer and would have most likely had absolutely zero progress to show for the agony. I had thought for sure that the miscarriage must have been nearly over and found that it was not even close to completion. I was crestfallen when the gynecologist gave me the information that I wasn't dilating.
This experience has filled me with concern for my next childbirth experience because I worry about the same damn thing happening. Trying to push out a 10-week fetus without appropriate dilation isn't likely to injure a cervix, but trying the same thing with an 8-pound full-term baby could really cause serious problems. Sure, screwing up your cervix when you're delivering your last child isn't all that big a deal (except that it is), but I still kinda hope that we might end up with a third child. I know, I must be friggin' high, but there you go. I'm not willing to try vaginal birth and I'm totally okay with an OB getting wrist-deep in my insides. Actually, for the first time in over 2 1/2-years, I'm totally okay with my son's Cesarean birth too.
I find it odd how quickly and completely I have changed my mind on these topics. I guess the event was just that horrible. . .I don't know if I'll revert to my original opinions, but I just don't see it happening at this point.
1. I will never, never, never take the "wait & see" approach should I experience another miscarriage.
2. Screw VBAC, I most definitely want a CBAC should I experience another full-term pregnancy.
What was so bad about taking the wait & see approach to this miscarriage? I have found that the emotional cost was too high to ever choose expectant management (the technical term for wait & see) again. Based on the physical experience itself, I'm not sure that it was possible for me to go the all-natural route. It certainly was not happening this time around and I have been scared away from ever considering it again. Yes, the D&C sucks, but I think it was lame to go through all the suffering beforehand only to have to have a D&C anyway. I'm fairly certain that is why I've found this recovery to be a little more difficult than I expected.
I do, however, feel that expectant management would have been perfectly fine had I not been as far along as I was because very early (like way the heck early) miscarriage is a lot like a heavy period. A somewhat chunky and heavy period. So it's both gross and sad.
I have written several blog posts on why a drug-free vaginal birth is my personal holy grail of childbirth so I'm sure it's surprising that I'm more than willing to voluntarily ask for a c-section if I ever give birth again. Not just more than willing, I mean I will outright say that I will absolutely get sectioned and I'm not willing to have a trial of labor. I just will not do it.
Why did this event cause me to change my mind about my next childbirth experience? Because my cervix WOULD NOT DILATE even though I HAD TO PUSH. This has me totally mystified. I feel like my body somehow betrayed me because the urge to push was undeniable and totally unstoppable and the pushing was really for no purpose because my cervix wasn't anywhere near to being ready.
I didn't just want to push, it seriously was all that I could do at a certain point during this ordeal. Pain and pushing, pushing and pain; that's what stands out in my head about last Wednesday. I tried a few positions to get things moving on out and had no luck; I straddled the toilet, I did an odd kneel/squat beside the toilet (when I was still vomiting), I sat on the toilet with my feet on a step stool and my knees drawn up & spread wide. I pushed and pushed and pushed. Nothing happened!
I was PUSHING with everything I had, but nothing happened because my cervix was still pointing in the wrong direction and still would not dilate! I could have pushed for hours longer and would have most likely had absolutely zero progress to show for the agony. I had thought for sure that the miscarriage must have been nearly over and found that it was not even close to completion. I was crestfallen when the gynecologist gave me the information that I wasn't dilating.
This experience has filled me with concern for my next childbirth experience because I worry about the same damn thing happening. Trying to push out a 10-week fetus without appropriate dilation isn't likely to injure a cervix, but trying the same thing with an 8-pound full-term baby could really cause serious problems. Sure, screwing up your cervix when you're delivering your last child isn't all that big a deal (except that it is), but I still kinda hope that we might end up with a third child. I know, I must be friggin' high, but there you go. I'm not willing to try vaginal birth and I'm totally okay with an OB getting wrist-deep in my insides. Actually, for the first time in over 2 1/2-years, I'm totally okay with my son's Cesarean birth too.
I find it odd how quickly and completely I have changed my mind on these topics. I guess the event was just that horrible. . .I don't know if I'll revert to my original opinions, but I just don't see it happening at this point.
Tuesday, January 4, 2011
Strategically Planning My VBAC
Fail to plan, plan to fail.
Let's say I made a resolution to lose weight (obviously not gonna happen since I'm PG), but I don't give any thought to making that goal a reality. At the end of the year, do you think I'd be successful in my weight loss endeavours? Probably not. Why would I fail? Because a goal without clearly defined action steps to make it happen is just a dream. And dreams don't often become reality.
Though I had a cesarean with my son, I want a vaginal birth if at all possible this time around. I realize that I can just tell my OB that I want another C-section, but I don't want to be put in the position to care for my busy toddler and a newborn while recovering from major abdominal surgery. Yeah, I know that some might think I'm crazy to voluntarily decide to "suffer" for no reason or whatever excuse one might use to opt for an elective c-section, but I've already explained in a previous post why a vaginal birth is better than a surgical birth (except for true emergency situations - not 33% of births).
Here's my VBAC plan so far:
- My health insurance company, Kaiser Permanente, encourages VBAC. This is very important because the policies of some insurance companies stick with the line of thought that says, "once a cesarean, always a cesarean." Of course, these archaic policies (which make no sense as they are not supported by the latest research or studies) thwart VBAC plans.
- I have already informed my OB that I do not want another cesarean and I have him on-board with my VBAC plan. He looked surprised that I had already been thinking about this birth, but he's about as supportive as it gets and seemed happy with my decision. He did inform me that I have an increased risk of experiencing uterine rupture, which (if not caught) can be fatal. But my OB is honest and he let me know that it only happens around 1% of the time. Since cesarean deliveries come with all the risks of any major surgery, I'm comfortable with the odds that I will not suffer uterine rupture.
- I looked up the VBAC rate at the hospital and my hospital has the highest VBAC rate (an impressive 22% of births!) in the entire county. Again, this is important because hospital policies absolutely interfere with childbirth plans. My hospital's personnel staffing also seems like it would encourage VBAC because the OB's are staffed with a shift schedule. That is, the doctor is there and getting paid the same whether you deliver or not and they leave at the end of their shift, not when you finally deliver. So I won't likely have to hear the biggest nonsense excuse for c-section: "failure to progress."
- I'm educating myself on the childbirth process. I've been mining the internet for information whenever I have a chance and I will be picking up some particular books to get as much knowledge of the labor and birth process as I can possibly get. I took Lamaze classes during my first pregnancy and I plan to take Bradley classes this time around. The Bradley Method is taught in a 12-week class and an overwhelming amount of Bradley students have the impressive birth outcomes that I also want - non-medicated vaginal birth.
- I'm already incorporating Bradley exercises and dietary guidelines whenever possible. I've had a few weeks of absolutely terrible morning, noon, and/or night morning sickness so I haven't done much yet, but I'm aware of what I need to do (thanks to that research I mentioned above!) and I'll be on it once I'm back up to speed.
- I'm educating myself about VBAC and it's risks. As far as I can tell at this point, I'm a good candidate for VBAC. I intend to refuse any "routine" interventions (unless they truly are medically necessary - no, the hospital staff's schedule is not a medical necessity) so I should be able to side-step the snowball effect that often results in cesarean. I also am prepared to refuse labor induction since it frequently ends up in a C-section and, of course, a failed VBAC. By being healthy and active throughout this pregnancy, I expect that I will remain a good candidate for VBAC. Of course, I'm assuming I won't end up with another baby who flips into breech position at the very end of my pregnancy.
I'm not leaving this birth up to my hopes or chance, but is there anything else you can think of that I should be doing to help see my VBAC dreams become a reality?
Let's say I made a resolution to lose weight (obviously not gonna happen since I'm PG), but I don't give any thought to making that goal a reality. At the end of the year, do you think I'd be successful in my weight loss endeavours? Probably not. Why would I fail? Because a goal without clearly defined action steps to make it happen is just a dream. And dreams don't often become reality.
Though I had a cesarean with my son, I want a vaginal birth if at all possible this time around. I realize that I can just tell my OB that I want another C-section, but I don't want to be put in the position to care for my busy toddler and a newborn while recovering from major abdominal surgery. Yeah, I know that some might think I'm crazy to voluntarily decide to "suffer" for no reason or whatever excuse one might use to opt for an elective c-section, but I've already explained in a previous post why a vaginal birth is better than a surgical birth (except for true emergency situations - not 33% of births).
Here's my VBAC plan so far:
- My health insurance company, Kaiser Permanente, encourages VBAC. This is very important because the policies of some insurance companies stick with the line of thought that says, "once a cesarean, always a cesarean." Of course, these archaic policies (which make no sense as they are not supported by the latest research or studies) thwart VBAC plans.
- I have already informed my OB that I do not want another cesarean and I have him on-board with my VBAC plan. He looked surprised that I had already been thinking about this birth, but he's about as supportive as it gets and seemed happy with my decision. He did inform me that I have an increased risk of experiencing uterine rupture, which (if not caught) can be fatal. But my OB is honest and he let me know that it only happens around 1% of the time. Since cesarean deliveries come with all the risks of any major surgery, I'm comfortable with the odds that I will not suffer uterine rupture.
- I looked up the VBAC rate at the hospital and my hospital has the highest VBAC rate (an impressive 22% of births!) in the entire county. Again, this is important because hospital policies absolutely interfere with childbirth plans. My hospital's personnel staffing also seems like it would encourage VBAC because the OB's are staffed with a shift schedule. That is, the doctor is there and getting paid the same whether you deliver or not and they leave at the end of their shift, not when you finally deliver. So I won't likely have to hear the biggest nonsense excuse for c-section: "failure to progress."
- I'm educating myself on the childbirth process. I've been mining the internet for information whenever I have a chance and I will be picking up some particular books to get as much knowledge of the labor and birth process as I can possibly get. I took Lamaze classes during my first pregnancy and I plan to take Bradley classes this time around. The Bradley Method is taught in a 12-week class and an overwhelming amount of Bradley students have the impressive birth outcomes that I also want - non-medicated vaginal birth.
- I'm already incorporating Bradley exercises and dietary guidelines whenever possible. I've had a few weeks of absolutely terrible morning, noon, and/or night morning sickness so I haven't done much yet, but I'm aware of what I need to do (thanks to that research I mentioned above!) and I'll be on it once I'm back up to speed.
- I'm educating myself about VBAC and it's risks. As far as I can tell at this point, I'm a good candidate for VBAC. I intend to refuse any "routine" interventions (unless they truly are medically necessary - no, the hospital staff's schedule is not a medical necessity) so I should be able to side-step the snowball effect that often results in cesarean. I also am prepared to refuse labor induction since it frequently ends up in a C-section and, of course, a failed VBAC. By being healthy and active throughout this pregnancy, I expect that I will remain a good candidate for VBAC. Of course, I'm assuming I won't end up with another baby who flips into breech position at the very end of my pregnancy.
I'm not leaving this birth up to my hopes or chance, but is there anything else you can think of that I should be doing to help see my VBAC dreams become a reality?
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