Friday, May 31, 2013

Decision Time

Tomorrow I will be 39 weeks pregnant. 

That is the most pregnant I have ever been.  Ainsley was born via C-Section at 39 weeks due to an incorrect ultrasound saying she would be over 10 pounds and that her abdomen, because of diabetes, was larger than her head.  I'm really not sure if that was the case.  It wasn't really brought up again.

Freddie was born via C-Section at 38 weeks because of the onset of pre-eclampsia.  Although, the more I learn about stuff like that, the more I realize, I don't think I was in any danger.  Yes, my blood pressure was up, it was in the 150/90 range.  Yes, that's high...but it's not as high as it usually is in pre-eclampsia.  Yes, there was protein in my urine...but trace amounts.  I know how dangerous pre-eclampsia can be, but I probably could have waited a bit longer.

During both of my previous pregnancies I never showed any signs of labor.  I never dialated, barely effaced, the baby never dropped, I never felt one contraction.  I was also very uneducated about the birth process.  I trusted my doctor.

She's a good doctor.  But I do wish I had been more knowledgeable back then.  I would have pushed back more, asked more questions, pointed out different things, because she is human.  Humans make mistakes.  I'm not saying she did.  I'm not saying that I wouldn't have ended up with a C-Section either way, but I do wonder.  I do believe that she was concerned about my well being in both cases.  And I do not look back on either of my childrens' births with regret or trauma.  Some women do, and I'm sorry for them because no matter how a child is born, it is a beautiful thing.

But...

Going into this pregnancy, I was fairly convinced I wanted a VBAC.  I prepped for this pregnancy.  I started reading and learning and asking questions.  I learned a lot.  I went from the girl who absolutely thought natural childbirth was insane, to completely understanding why women make those decisions.  I went from the girl who couldn't believe ANYONE would birth in their home, to being in awe of the women who do.

The year before I got pregnant I lost 20 pounds.  I wanted to be as healthy as possible.  I wanted to give us the best chance at a VBAC.  Once I was pregnant, I continued to be healthy.  I knew that if complications started, my already uphill battle would become nearly impossible.  And I told myself, if this is a complicated- free pregnancy, I will have a VBAC.

But...

It wasn't. 

My blood pressure has been up and down.  I have diabetes.  The baby is measuring large.  The baby's abdomen, even with a second opinion, is measuring larger than his head.

My new doctor?  I like her...a lot.  She's no bull shit.  I've asked her every question I wish I would have asked 6 years ago.  And she's answered, very honestly.  She told me in 21 years she's only seen one uterine rupture, and it ended fine.  In 21 years, she's seen some cases of shoulder dystocia, and even the worst case ended up being okay.

But still, it's out there.  These words and phrases just swimming through my mind...Uterine Rupture, Shoulder Dystocia.  And the fixes for them...hysterectomy, breaking the pelvis, breaking the baby's clavical, pushing the baby back in and having a C-Section, fetal mortality.  These big fears.  I have a high risk of both.  Now, high risk in both of these cases is under 3%.

But...

What if I'm in that 3%?  It doesn't matter if the chance is low.  If it happens to you, it's tragic, and its forever.

On the flip side, if I move forward with a third C-Section, there's the chance I'll drop from a blood clot a week later.  There's a chance that my internal scarring is bad enough that my decision to have a 4th child or not will not be mine.  There's a chance I'll get some horrid infection in the hospital.

This has been weighing on my mind for months.  How I want this to go.  What my plan is.  And now it's decision time.

I've decided to go with my original plan...if I have a complicated-free pregnancy I'll have a VBAC.  Unfortunately, I have not had that.  So I have scheduled a repeat C-Section.  I don't feel great about it, but I didn't feel great about it before I made this decision either.  I'm a worrier, the worst possible outcomes are going to consume my thoughts until it's over.  I am thankful that I will be the full 40 weeks when it happens.  No early deliveries.  If I go into labor before then, I will labor and see what happens.  So I guess I'm leaving it to the universe to help make this decision.  However, I'm showing no signs of labor as of yesterday.  But then again, I've never been past 39 weeks, so who knows.

I can't go back and change the past.  I can only move forward and make the best possible decision I can with the information I have.  I hope I'm doing that.
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