Sunday, June 10, 2012

You might not want to read this....

(Fair warning…this is a trip inside the head of a very pregnant lady who has too much time to think these days. And it's long. You may not want to keep reading! But scroll to the end for a belly picture at least!)

Holy cow. I have 6.5 weeks left. Six and a half short weeks until my “due date” rolls around and I start to get anxious about whether Yellow will actually come close to on-time or not.

Who am I kidding? I’m already anxious about whether Yellow will follow in his/her sibling’s footsteps and decide to come as close to the 40 week mark as possible. Why the anxiety? Because I’m trying to have a VBAC (vaginal birth after caesarean) and, although my midwife is good with not even considering a repeat c-section until I’ve gotten to 42 weeks, she works for/with OBs who are not as confident in that plan.

That’s really the least of my anxiety right now, though. My big, giant, huge, enormous, hang-over-my-head all day, every day anxiety is just having the VBAC in the first place.

I’m a huge proponent of natural birth. I don’t generally like our obstetrical model of care here in the United States. I feel like doctors - and society in general - do a good job of convincing mothers that somehow giving birth needs to be medically managed instead of just helping us trust our bodies and being there in case something really goes wrong. I think that modern medicine is fabulous when it’s necessary. I think the problem with our current obstetrics model of care is that OBs seem to think that a woman can’t possibly have a baby without all that modern medicine and, in fact, many OBs have never seen a truly natural birth. It’s true; knowledge of surgery has definitely saved many a mama and baby since it became something that doctors know how to do, but it’s also been used unnecessarily way too many times for me to fully “trust” the system.

There’s a term used often in the “natural birth community” to describe the overzealous use of surgery – the “unnecesarean.” I’m not going to say that my c-section with Michaela was totally unnecessary, but I feel like, even though I tried for a fully natural birth, I allowed for at least a few interventions that probably helped contribute to my section. It took me weeks (months) after M was born to sort of mourn the loss of the birth I’d always pictured I was going to have. That probably sounds weird to some people, but when you spend your entire pregnancy planning to not have any medication, to basically forego all medical interventions, it can be a little bit heartbreaking to end up with the ultimate medical intervention – surgical birth. It took me nearly ten minutes to sign the consent form for the surgery; that’s how much I did not want a section.

My dear friend Abbie told me, just a few days after Michaela was born, that “the only unnatural birth would’ve been if you’d delivered her out of your nose!” That helped a little, but it’s really taken me almost this past three years to come to terms with what led to my c-section, and to feel like I didn’t completely fail at doing what my body is made to do. But I also know that there are things I could’ve done differently to help prevent the section. It might not have been totally unnecessary, but I’m still not convinced it was fully necessary either.

So that leads us to today. Well, this whole pregnancy, actually. Well, since we started thinking about having another baby, really. I have researched the risks versus benefits of VBACs, I’ve read a bazillion birth stories of all sorts, and I’ve analyzed and over-analyzed what happened with Michaela. All that led me to the pretty easy decision to want a VBAC, and to do whatever I can to make it as safe as possible for me and the baby.

I won’t get into the whole story about my first appointment with an OB here – where I ended up sobbing in the office at the words, “No. You’re not a VBAC candidate.” It’s not pretty, and the good that came out of it made the visit worth it. The good is that I found a wonderful midwife instead, who’s question to me at my consult with her was, “So why are you here?” I replied, “Well, I guess to find out if I’m a candidate for a VBAC, or if you’ll take me on.” Her answer? A simple, “Why wouldn’t you be?”

Since that consult when I was somewhere around 14 or 15 weeks pregnant, I have never once questioned my choice to see my midwife. I’ve never questioned my choice to switch hospitals to the one that’s WAY farther away to not only be able to use the midwife, but to have a more natural-birth-friendly atmosphere. And deep down, I don’t think I’ve truly questioned my decision to go for the VBAC. But the closer the time comes – and the more my body tells me how much less its enjoying being pregnant this time around (dude, I’m old), the more I wonder if I’m insane.

I mean, what could be easier than a repeat c-section, right? Schedule the day (much easier to have childcare set up for Michaela), no mess and fuss of actually laboring again (my labor with Michaela was NOT pretty), no worrying about having the “fight” with the on-call OB about whether or not I’m progressing quickly enough, no money to spend on a doula… well the list could probably go on. Sure, there are risks associated with a c-section – ones that some OBs often sort of gloss over – but people have c-sections every day. We’re told that the increased risk of hemorrhaging, possible incision infection, increased difficulty with establishing breastfeeding, and the various other risks aren’t anything to be too concerned about. So how bad could it be? Well, there is the whole cutting open your abdomen thing. And that’s not fun.

Meanwhile, what I get with a VBAC is the potential for another long, painful labor (I’ve been doing whatever I can so far through this whole pregnancy to try to keep this baby positioned correctly for an easier labor – my big issue with Michaela being that she was asynclitic, or crooked), the “fight” if things don’t go text-book and the on-call OB starts harassing my midwife about moving me along (I will NOT have any pitocin this time around unless there’s no other way this kid is coming out), the anxiety of trying to labor at home as long as possible without waiting TOO long to make the trip to the hospital, the expense of the doula/birth assistant (who is already worth every penny!), and don’t forget that small risk of uterine rupture (which, by the way, is less of a risk than all those c-section risks, but it’s still there).

But, seriously. I want to go through labor again!?!??! And without drugs, again (even more so than last time). What am I, insane??? I am truly not worried about *the* major medical risk associated with a VBAC; Because the risk of uterine rupture is less than 1% in a VBAC labor that is not induced or aided by pitocin (neither of which I’ll be doing), I personally feel that I’d be taking on more medical risk with the c-section. But with the VBAC I’m taking on labor! UGH! Contractions. Cervical checks (there will be very few of those). Back pain. And then pushing. Oh. Pushing. Yeah, didn’t actually get to that with Michaela…. not really excited about it, to be honest. It’s weird to be having a second child, but feeling like it’s a first because, although I certainly experienced labor, I have no idea what to expect for the pushing and after. And I’m scared.

There, I said it. I’m scared. I’m scared that I’ll have a similar labor, which I don’t know how I’ll manage again. I’m scared that this baby will also be crooked. I’m scared about actually having to do the work of getting the baby out. I’m scared about third stage. Then I’m also scared about *not* having the VBAC. I’m scared about going through all the work like I did with Michaela and then ending up with a c-section anyway, or, even worse, not getting the chance to labor at all. I’m scared about the possibility of c-section recovery with a newborn AND a 3-yr-old. And then, either way, I’m scared that our wishes for care of the baby after s/he’s here won’t be followed (a new fear after our meeting with our doula this week – YIKES!!). And I’m definitely scared of what our family is going to be like when Michaela is no longer the only child.

*Sigh* I trust my body to do what it was made to do, but having “failed” before (and I put failed in quotes for a reason… I don’t think I failed, per se, but it’s sort of the closest word I can think of describe not actually having a vaginal delivery with M), it’s also difficult to fully trust that things won’t go “wrong” again this time around. I know I’ve done what I can while I’ve been pregnant to set myself up the best possible way for this VBAC (good nutrition, physical therapy to get my hips lined up right, finding an awesome midwife and an awesome doula, and using positioning techniques from to keep the kid straight), but it’s still so daunting to give up the “easy” of the repeat section to try to do it naturally again. And did you know there will be a new baby at the end of all of this!?!??!

What did I tell you? Ramblings of a very pregnant lady (even more pregnant when I actually first started typing this up over a week ago!!) with too much time to think on her hands!

Meanwhile, here’s a picture from two weeks ago. I’m bigger than this now. Oh yeah… add another fear… I’m afraid I’m growing another ginormous baby!!! I need this kid to stay around the 8lb mark instead of hovering near 9lbs like Michaela!!

Belly Watch 2012
(pictures taken at 31w2d, about 2 weeks ago)