Tuesday, December 04, 2007

I report, you decide

So Maggie's birthday just happened, and I have been working on a post about how wondrous it is that my sweet angel girl who was a baby like a WEEK ago is now three. With all that three entails (she agreed with me this morning that she is ready for her own job and own place, just for starters). It's sappy and horrible so I'll spare you, but suffice it to say the last three years have been more joy-filled, even with a lot of crap that's gone down, than I thought possible because of that delightful little girl. One of the amazing things about parenthood is that you get to bring your favorite person into the world. All my other favorite people I met because I lived with or near them, or stumbled into the right party, but this one? I have gotten to know since the minute she was born.

So, sappy over. I have a major life decision to make, peeps, and I cannot decide. So, I am consulting my friends inside the computer to see what you think.
Namely: VBAC or repeat C-section?

Here are the facts playing into my decision:

--I recovered very well and quickly from the c-section for Maggie. No complaints, no complications, I was able to breastfeed just fine. Same doc and same hospital this time, so I'm expecting the same outcome if I have a c-section again.

--I did not have a snuggly 36-pound child at the time.

--I would have to be away from said 36-pound child for a LONG time--the one mistake I made when in the hospital with her was going home after two days and I am NOT doing that again. It was too soon. I needed more rest. This time, while Paul is fully on board with making sure I take it easy, there is, again, the Maggie factor. She will need attention and care, and I feel like if I opt for a repeat C it's better for me to take the full hospital time so I don't do stupid things like attempt to play with her and carry her around like I usually would (I am a DAMN stubborn Polack). I'd be gone probably four nights, and I have never been away from her that long nor do I want to be -- but I don't want to risk my own health by attempting to recover at home where I know my usual obligations will be tempting me to overreach.

--This will be my last go-round, barring a spectacular reversal of PCOS and failure of birth control, and I might never get to experience a vaginal birth. I want to, want that "I did it!" feeling of triumph so many women seem to have. I want to smack the earthy-birthies who refer to c-sections as not giving birth, because hello, the baby was IN and now it's OUT, but I also want to experience what a normal one is like.

--I am fully aware that I could go in there with the best of intentions and end up laboring for hours and STILL have a c-section. I have no idea of what labor might be like for me. With Maggie, my water broke at 2 am and she was born just after 8 -- I tink we were in a room at the hospital for less than two hours. Her heart rate was dropping -- and twice almost stopped -- because her cord was wrapped around her neck and compressing against something. I was so miserable emotionally during that time, so full of horror and fear that after everything I could be losing this baby, that even the mild labor pain I was feeling receded into the background. I don't know at all what it would be like to go thrugh labor so I can't draw any conclusions from that.

--I am terrfied to my soul of the same thing happening if I try to labor again. Those few hours were without a doubt the worst thing I have experienced, and three years of a perectly healthy and energetic girl later I still get panicky and teary-eyed thinking about it (despite reassurances from my doctor and Karen the wonderful nurse practioner that we were being monitored all the time and if she went into serious distress they would have had her out so fast my head would have spun). A scheduled C would be free of all that fear -- just march in at 39 weeks, a brief surgery and hello baby! That's enormously reassuring to me --that the birth of at least one of my babies could be free from such wrenching fear. I feel terrible when I think of Maggie's birth, not because of how it happened (I was pretty close to asking for the scalpel myself just to GET HER OUT where she could be cared for if need be) but because of the awfulness that led up to it. I'd love to be in a good place emotionally to greet my baby, instead of numb from shock and fear.

--That being said, I hate to this day that I couldn't hold her immediately and that it was Paul who got to go off with her while I had to be stitched up and wait in recovery. With a vaginal birth I could greet him right away.

-- I would HATE laboring for God knows how long and STILL having to have a C-section, even if labor goes OK. And I do fall into several categories that put me at higher risk for a C-section even without having had one before --overweight and older being the two most significant.

-- I went a week overdue and damn near lost my shit. It seems, based on my friends's experiences, that if you go late once you always go late and same thing with going early.

--Paul would prefer I have a c-section because have had more discomfort with this pregnancy and he's afraid of something going really wrong (like uterine rupture--not a concern of mine bcause according to my doc it happens less than 1 percent of the time). He's leaving it up to me, though.

Now, if you are yourself a sanctimounious earthy-birthy and think c-sections are the worst thing to happen and women! are such victims! of a cruel and uncaring medical establishment! kindly keep your comments to yourself (regular old earthy-birthies can fire away, I just don't want to hear that c-sections are evil and women who have them are weak because having one saved the life of my baby thank you very much). I have a very trusting relationship with my OB. We've talked about this already and he refuses to push me one way or the other (despite my TRYING to get him to, DAMN YOU DR B). My main goals with this birth are 1) not to be fucking terrifed like I was with Maggie and 2) live me, live baby. That's it.

So, what do y'alls think?


Oz said...

Love what you said about parenthood giving you the chance to bring your favorite person into the world - Axel's already my favorite, and he's only a month old!

As for VBAC or another C, I'm not much help. The cord was around Axel's neck, and his HR fluctuated, but not to the degree it sounds like you experienced. It sounds like opting for the C might help preserve some peace of mind for you, but, given your trusting relationship with your OB, it sounds like you could feel confident/safe if you decide to try VBAC

Karen said...

Listen, after FOUR births of varying degrees of wonder and suckiness, all I can suggest is that you choose whichever will make you feel the least stressed and give you, ultimately, the most joy.

caramama said...

First, I also love what you said about bringing your favorite person into the world and knowing them since their birth! What a cool way to look at it.

Second, you have a tough decision to make--mine is pretty decided. I also ended up with a C-section, but after 16 hours of labor and being stalled at 8 cm for 5 of those hours. Apparently, a 9'5" baby was not a good fit for my body. Who knew?

I asked my doctor about possibly doing a VBAC, and he said we couldn't be sure the next baby would be smaller, so I should not try to do a VBAC. But that is a different situation than yours. So not really helpful except for the fact that my next L&D will likely be similar, but you don't have that assumption.

The last point I wanted to mention is that I've heard from my sister that there is research showing that VBACs can actually be more dangerous than having another C-section. Something about the fact the uterine walls have been weakened by the incisions? But I don't know the research personally and haven't started to look into it because I'm not there yet. I don't want to mention this, scare you, and then you/I find out it's inaccurate, but it's something to look into. FWIW, my sister is a very pro-natural birth person, so I took it seriously.

All that being said, I have a friend who did a VBAC after two previous C-sections, and all went well and she was happy with her decision.

Good luck! Sorry this is so long!

Linda said...

I am, I think, a regular earthy-birthy after giving birth to 3 kids the unmedicated vaginal way. That said, in your situation, I would do a repeat c-section. Yes, there are risks and those should not be minimized. But if I put myself in your situation and include everything you just posted, that would be my choice. You asked, so take it as you will.

Anna said...

I am totally voting for the C-section. In my line of work, I have seen too many problems resulting from VBACs. And to put it into perspective, the chance of a problem (uterine rupture, compromised oxygen to baby, fetal and or maternal death) from a VBAC is VERY small, if it happens to you, it won't matter what the chances were. To me, it's not worth the risk.

After pushing for 3 hours, I could feel his head I just couldn't push him out. So, exhausted, I had a C-section. When I told my doctor that what mattered most to be was a healthy baby and a healthy mother, I really meant it. I would absolutely go for a repeat C if I should ever be blessed enough to get to that point.

So! Sorry to sound like such a downer, but you did ask ; )

On a cheerier note, congratulations again on the impending boy! From someone who didn't realize having a boy was even an option, mine has been an absolute delight. Even with the tantrums, I never imagined being so happy to be a mom. Don't worry, you'll be fine!

tripmom827 said...

I can't really offer advice, only give my experience. I LOVED my two VBACS. I couldn't have ever imagined what a powerful, beautiful experience it is to birth in that way. It is amazing to be able to see that precious little angel laying on your tummy in all of his/her magnificence one moment after birth.

Also, my first experience was a scary C-Section and being able to give birth vaginally has been such a healing thing for me. It has helped, though I don't know why or how, to heal the scars that first birth left.

Also, I haven't seen any research that VBACs are more dangerous than a repeat C, and I've done lots of research. I was able to have an epidural with both VBACs. I was induced with Hayleigh. Pitocin was used with Ryan also. I am old too and I am fat as hell. I know I am lucky.

I think you have the benefit of your previous experience, maybe they can do biophysical profiles the last few weeks to see how baby boy is doing. Maybe you won't lose your shit so much if you expect that you'll go a little late. Of course, on the other hand, if you are very nervous about something going wrong, I think that would make it difficult to labor. Which is why I can't give you advice. Only you know how you are going to feel.

Whatever you decide, his birth will be amazing, since he's a new little life to love!

BrooklynGirl said...

I went through much the same decision making process and opted for repeat section. I have no regrets: recovery was fine, and I was lifting my toddler much sooner than I had thought I'd be able to.

Though it wasn't the deciding factor, I did find the scheduled component of the section pretty darn convenient.

apt said...

How wonderful that your dr. and hospital are giving you this option.
You get to decide how you would ideally like your birth to go, not how it actually goes (as you know from Maggie). When I finally realized that I really wasn't in charge of how Willa's birth went, I felt relief.
Sounds like you're confident with your OB (and that the OB is confident in VBAC being an option). If you wanna give it a shot and you're in the hospital with people who are taking care of you and baby go for it.
Unless that thought scares you past the point of being worth it. And only you can decide if it's worth it.
If need be, Maggie will be okay with you being gone for 4 days. And you'll adapt the affection giving if you are unable to lift her for a while.

caro said...

I think you're smart to consider the separation from your daughter. For me, seeing how my daughter reacted to just the (unprecedented) two-day separation when baby sister was born (vaginally), that factor alone would swing me to try for a VBAC. I think the separation really added to the trauma of baby sister's arrival for her. But your kid is a bit older, and of course every older sibling is going to react differently.

Also, maybe this is an earthy-birthy thing to say, but I think there are some health advantages to the baby if you go through any amount of labor, whichever way the babe ends up coming out. Something about the hormonal changes all that squeezing preparing the baby to breathe well?

Sorry if that sounds heavy handed. I do see the other side, especially your fears around how emotionally miserable labor was last time. On the other hand, it sounds like it could be really healing (oooh, I said healing. definitely earthy-birthy there) if you have a good experience with a VBAC.

elererah said...

I'm a first time preggers woman trying to decide between different birthing methods right now. My mom went natural (maybe with IV pain relief) for all three of us and a miscarriage. She said it's not that bad (kind of like menstrual cramps). She used Lamaze. The epidural looks more scary to me, personally. But you have to get one with a C-section anyway, I think. I have never heard anyone dis any method of birthing and I can't really imagine anyone being seriously snobby about something like that. (although I'm sure it's out there) All methods are going to painful. Personally I'm trying for the natural birth, but with the caveat that if I want an epidural I'll have one; If I have to get a c-section I'll get one; If I can't nurse, I'll still be ok.

Denial is a wonderful thing. I tell myself that everything will be ok. Everything will be OK. No matter what. Just don't watch Discovery Health!

In the thick of it said...

I've mulled this very thing over myself. Although it's much more pressing in your case =) I think, in another lifetime, I would be earthy birth girl. You know me, Amy... being a mom has brought out my inner hippie. But in reality, because of Riley and IF and all those other complications, I am super-medical birth girl.

I toyed with the idea of a VBAC. I have had a vaginal birth, but it was not the dreamy experience I was longing for after my c/s. And while I was "fine" with my c/s, there were definitely things I did not like. Mainly, like you, I *hated* being the last person to hold my own child. Yeah, I got to see him... for about 3 minutes before they whisked him away and I was left to be sewn up and sink into a morphine haze. Jonah's birth was still... miraculous. The thought of it still makes my eyes well up with relief and joy and immense love. But I wanted him immediately in my arms, latched to my breast, gazing into my eyes. Instead he was rushed down the hall to meet his extended family. Which, in it's own way, was appropriate since those people are all such huge forces in his life. But still.

In the end, my decision, should I ever have another child, is to have a repeat c/s. First, despite the low risk with VBAC, it still seems scary to me. And I don't think I could forgive myself if something happened and it was all kind of because I wanted to have a specific birth experience. Second, the risks with VBAC are greatly increased if you induce. Knowing my history, you also know there is a good chance I would end up having to induce. Also, a real factor was that my hospital does not allow VBACs and my doctors only deliver at this hospital. I love my doctors. I love my hospital. I don't want to have to go 30 miles to deliver my child.

Are there benefits to a vaginal birth? Yeah. Would I prefer one to a c/s? Yeah. But in the end, it is just not meant to me. And I do not spend a lot of time dwelling on it. I'm too busy being totally in love with my wildly hilarious, far too smart 3 year old.

Em said...

A belated happy birthday to Miss Maggie!

I'm biased toward a repeat C. I have a friend who is in the one percent who rupture during a VBAC. It was scary for her and for her baby (whose oxygen was certainly reduced). I know the risk is low, but it scares me all the same.