Friday, September 16, 2011

Changing my mind...

  I figure, as a pregnant women, you have a built in right to be fickle.  To change your mind whenever you want.  To love Mexican food one day, and just the thought of it the next day makes you want to vomit.  I think for all the work and strain growing a baby can cause, the right to change your mind should be a given! 
  Also, when you consider all the plans and decisions that a baby brings into the picture, it makes "making up your mind" a very difficult task sometimes.  I don't typically find myself to be a wishy-washy person.  There are just a few things I am finding it hard to decide about, and others decisions that I don't have as much control over.  Or that I will have to wait much longer to decide what is right.  I HATE being in limbo!  I like making a plan!  I don't mind adapting or changing a plan, and I find myself pretty flexible when it comes to these things.
  Seems like the rantings of a hormonal preggo lady?  Guess you are right.  Its just a few things have been weighing on my mind and there is just no answer in sight.  The biggest decision (or choice) I am facing is about the delivery of the baby.  When I was pregnant the first time, I only just worried about what delivery would be like, but not really how different my expectations would be from reality. 
  A bit of a background of my baby deliveries:  at 38 weeks 1 day with Lilly, I started "leaking" fluid in the afternoon.  By the next morning, still leaking but not in labor I went to the hospital.  I was strep B positive, so they induced labor with pitocin.  I started off barely a fingertip dilated.  After 8 hours I was only 2 cm and the pitocin was awful!  They just kept bumping it up and up and up and it was excruciating, and to top it off, not doing anything!!  8 hours after that, I got an epidural, I was only 4 cm, exhausted and ready to give up.  They let me labor a while longer, which didn't change my cervix, and because I had ruptured so long ago, they thought it best to deliver by c-section.  I gave in and in less than an hour, we had Lilly!  The recovery was painful, but I didn't know any different. I think I had a touch of post partum depression, which makes for not-so-good memories of those first few days and weeks.  You know what they say, "if I knew then what I know now......"
  With Ryley, I was determined to have a VBAC, a vaginal birth after cesarean.  It is quite common, very safe, and recommend by the American Academy of Obstetrics and Gynecology (AACOG) as the first choice for delivery of moms who are a "good candidate".  I qualified as a good candidate and did not want a repeat c-section!!  When I went into labor on my own at home at 38 weeks exactly, I was thrilled!  No pitocin for me!  (Besides, most docs won't induce a VBAC, it increases risk for uterine rupture)  I labored at home, then at work and then at home again for 12 hours.  It started slow and small, like it should and steadily got harder, longer and closer together.  When the contractions were only about 5 minutes apart, Carl took me to the hospital!  I was so stoked!  I was doing it!  I was gonna finally have what I wanted, a vaginal birth!  HAHA, NOT! says Ryley!  After I was settled in at the hospital, my water had broken by this time, the nurse doing the first internal exam says, "hmmmm.  I don't think that's a head down there."  EXCUSE ME?!  What do you mean not a head?!  In fact, when Dr. Horn came in with ultrasound, he confirmed her suspicions that Ryley was breech, her head up in my ribs!  Since I had had a prior c-section, I was not a candidate for a version, which is an attempt to manually turn the baby from the outside.  So, I was prepped for and wheeled into surgery, and at 3:56 am my stubborn Ryley girl was born butt first!  I have to be honest here.  I had a spinal block and not an epidural this time, and after surgery I could feel my legs really quickly.  The recovery from the second c-section was a breeze, even if I know it was more painful than the average vaginal birth.  I relished in my new baby daughter but a part of me was (is still) really frustrated!  I know it was not any one's "fault"  but I still feel kind of cheated!
  Every woman's body is built to have babies.  One hundred years ago, there weren't these extreme medical interventions.  I appreciate what medicine and technology brings to the table as far as safety, the health of the baby and my own health are concerned but I feel left out of what could be such a normal, natural thing.  Even though the AACOG still recommends VBAC as a safe alternative to elective c-sections, even after two surgeries, it is next to impossible to find a doctor that thinks a VBA2C (vag birth after two cesareans) is a good idea.  Indeed, risk for mom and baby does increase with each c-section performed.  But the risk of elective major abdominal surgery looms large too!  The risks for both are very real, and very different.  When meeting with my doctors, even early on, not one of them thinks a VBA2C is a good idea.  They all recommend elective c-sections at 39 weeks.  It also seems like they want to try to scare you with the risks that trying for a vaginal birth brings, but no one wants to talk about the risks for major abdominal surgery.  I definitely do not want to labor again, be disappointed again, and end up with a c-section again.  In that aspect, it might be nice just to schedule it and not have to ever labor.  But a HUGE part of me wants the whole natural experience.  Doing it the way nature intended.  Dr. Hess says she will support me as long as they are convinced baby is small (how are they gonna know that?!) and that I don't get too close to my due date.  At which time, she will insist I schedule a c-section.  There is ONE doctor in all of Kentucky that will work with, and recommends VBA2Cs.  He is one hour away, and does not take my insurance, so that is out of the question. 
  As I re-read this, I realize that it has turned into quite a long rant.  I didn't mean for it to turn out quite so long to read, and thanks to anyone who made it all the way to the end of my frustrating story.  So, despite it all, I am left to wait and see.  Wait and see if baby is "big or small"?  will I go into labor naturally?  early enough?  Can my body do it? but what about, can it do it in a way that allows the docs to let me have my way?  We all just want whats best for baby, but its not going to be easy to stand up to a doctor who also claims to have baby's best interest in mind.  But they are licensed professionals.  I am just a mom.  What do I know???