Wednesday, January 16, 2013

Pregnancy #2: 40 weeks, 2 days

Where to start?

Well, I guess I'll just start with the biggest thing.  The thing that's at the forefront of my mind that I haven't been able to stop thinking about since I found out.

Yesterday, at my 40 week midwife appointment we found out that baby has flipped to a breech presentation.

*Breathe in, breathe out*

I hate even typing that out.

For me, this means if she remains in that position I will not have the option of attempting a vaginal delivery.  After all of our careful consideration and considerable preparations to help achieve a successful VBAC this is quite a difficult pill to swallow.

Look, I realize that bottom line the most important thing is that we come out of this with a healthy mom and a healthy baby.  I get that, but even though that's the most important consideration here, that doesn't mean that there aren't other factors as well.  I want a better, safer, more natural experience for both myself and my baby this time.  I want a better chance at breastfeeding.  I want the shortest hospital stay possible so that we can get back to where I'm comfortable and start adjusting to life as a family of four.  I want an easier recovery where my uterus doesn't have to be cut open for a second time and I don't have to avoid picking up my toddler for weeks and weeks for fear that I'll rip open the incision and cause further complications.  I want to be able to bond with my baby (and return home to my toddler) without being in a medication induced haze trying to control the pain from a recent surgery.

Thankfully, Jack and I came out of our C-section experience more or less no worse for the wear.  I had a very long recovery, but that likely had to do with all the laboring I did leading up to the C-section.  I wasn't able to successfully breastfeed, and that was definitely the biggest thing that I felt we were robbed of, but thankfully Jack thrived on formula.  But I'm all too aware of the risks and possible complications that can be experienced and I consider myself lucky that everything went so smoothly last time.  It makes me nervous to take on those risks again, but I don't have a lot of options and it's really out of my control and I hate that.

Let's rewind a little.

You would think that a full-term baby flipping from vertex to breech presentation would be totally obvious.  First, it's unlikely to happen in the first place considering how little room is left for baby to manuever, and second, it's a fully grown baby!  How did I not feel that?

Looking back in hindsight a couple of things stand out.

To begin with, it's difficult for me to tell what position she's in anymore just because everything is so squished in there.  There aren't really any distinctive movements like there used to be, it's more big rolling sensations or little twitches more than anything.

There was a time last week (and I can't remember which day exactly) where I remember remarking to Mark that the baby was having a party in my tummy.  She was SUPER active, far more so than is usual, and this continued from the evening and even after we were in bed for the night.  Maybe that's when she flipped?

The only other change I've had is a drastic increase in pelvic pain.  I had been doing so well, and feeling so (relatively, anyway) good and then in the wee hours of Sunday morning (39 weeks, 6 days) I woke up to the feeling of a small amount of fluid leaking.  For a minute I thought that maybe my water had broken with a trickle.  So I got up and went to the bathroom and didn't experience any additional leaking so I decided it was probably (atypically for me) just an excess of watery discharge, strange as it was.  By the time I got back to my bed I was in a TON of pain.  My pubic bone (where I've had pain in the past) was quite angry and I had trouble just getting back into bed.  It was so sudden.  I was sure that what had happened was baby had quickly dropped down and her head was putting pressure on things causing the pain.   Maybe that's when baby changed positions?

I didn't have any additional leakage after that, but the pain continued.  The next morning I was still in a ton of pain, I was having trouble just getting around, and to top it off I couldn't even lay down without being in a ton of pain.  Sunday night was brutal as I couldn't get in a position where I wasn't in excruciating pain so I spent most of the night essentially sitting straight up in bed, dozing, as well has experiencing contractions every 30 minutes or so.  Around 4am I finally was able to lay down either because things had gotten slightly better or because I was so exhausted I wasn't even registering the pain, I'm not sure.

Monday was more of the same, but thankfully we did figure out a way for me to lay comfortably even though I needed Mark's help every time to get properly situated and it hurt like the devil to move at all after I was finally situated, but I still had to get up periodically to go to the bathroom and flip over to my other side.  Ugh, what a nightmare.

Monday night I took a shower and by the time I got out of the shower things had suddenly improved slightly.  I was still in a lot of pain, but things had downgraded from excruciating to move to just super painful.  I counted it as a win.

Now, while all of this was going on it sent me to a really negative place mentally.  I had been SO positive about how good I was feeling and I was feeling great about heading into my birthing time.  I was so sure that everything was going to go great and honestly the only thing I was worried about was how breastfeeding was going to go this time.  We were just waiting for things to start.  Once I was in so much pain it just really messed with my head.  I've said all along that I felt like I wasn't going to have any problem as long as I could keep the pelvic pain under control (which I had!) so once it set in so severely I already felt robbed of a normal labor and delivery experience.  My mind immediately went to worrying that things were going to be the same as last time.  It was really hard and I was honestly really anxious at the same time.

So I went to my scheduled appointment on Tuesday morning, anxious about discussing this new development with my midwife.  I already knew there was nothing they could do and nothing they could really tell me about what I could expect from labor and delivery, but I was interested to see what they had to say anyway.

I laid back on the table and we listened to baby's heartbeat, which sounded great.  The midwife measured my tummy and as usual she felt baby for positioning.  I did notice that she spent more time that usual doing that and was squeezing things a little more than usual, but I thought maybe it was getting harder to tell how baby was sitting just because everything is so squished in there at this point.  She usually tells me how baby is positioned, but she didn't say anything.  I didn't think anything of it because the exam wasn't over at that point like it usually is.   

Then we did (my first) cervical exam and she said I was 3cm dilated and 50% effaced, but that baby was still sitting up pretty high.  I was super surprised by this information considering I was sure baby had dropped and that's what was causing the pain.  She stood up and said, "let me feel baby again...".  She felt my tummy again and just looked at me and said, we need to get a quick peek in there.  I want to send you over for an ultrasound to check baby's positioning.  At this point, things still hadn't registered and I just sputtered, "huh?  Is everything okay with the baby?".  And she said, baby seems fine, but she thought there was a chance that baby had flipped to breech presentation.  She assured me that it's very uncommon for babies to flip this late, but that she couldn't confirm that baby was still head down so we needed to check.

The office ultrasound tech came to get me and we walked down to the lab.  She squeezed gel on my belly and put the wand to my lower tummy.  I was looking at the screen trying to figure out what the heck I was looking at (again, because everything is so cramped in there right now, it's hard to tell!) and she immediately said, "baby's breech".

I was just so shocked to hear this it didn't even sink in.  I had no idea what to say.  The ultrasound tech wiped off my belly and said she was going to get the midwife to come back and talk to me.  At that point... I wasn't even thinking anything.  I was just in complete shock and my mind was totally blank.

The midwife came into the lab and said, "I'm so sorry, I just want to cry for you right now, I know how much you wanted a VBAC.  We have to do a C-section".  Again, I just... I don't even think things were fully registering at this point.  So I said, "when?  When would we do that?".  And she started explaining that they would recommend I schedule a C-section as soon as possible, as in today or the next day.  She explained that considering I could go into labor at any time at this point, and as the days pass the likelihood increases, that a scheduled C-section would be best rather than waiting for labor to begin and arriving at the hospital in active labor with a breech baby needing a C-section.

I think we talked more about the risks/benefits of doing a C-section as soon as possible vs. waiting, but I honestly can't remember.  I told her I definitely wasn't ready to make a decision today so she walked me to the front desk and got me scheduled for an appointment next Monday when I'll be right at 41 weeks.  They'll want to check baby's positioning again at that point if I don't go into labor before then.  She told me to think about it, talk things over with my husband, and give them a call back to let them know what I was thinking and/or if I wanted to get the C-section scheduled and if we decided to wait they would see me on Monday if I still had an inside baby.

I barely made it to my car before bursting into tears.  I called Mark to tell him the news.

I feel like this is such a blow considering everything we have done to try to stack the deck in our favor.  Not to mention all along I've been specifically doing things to help with baby's positioning such as weekly adjustments with my chiropractor and special exercises.  I honestly wasn't even concerned about the possibility of baby being breech because it's a super low percentage of babies who are breech to begin with AND baby was already head down!  I was far more concerned with baby being posterior like Jack was.  I just can't believe that this is happening and that it's happening SO late in the game!

In addition to the fact that I could go into labor at any minute and that baby is breech, now I'm worried about WHY baby is breech.  It's so unlikely that baby would flip at this point, maybe she's trying to tell us something.  Sometimes babies are breech for a reason, like they're tangled up in their umbilical cord or there's a malformation of the pelvis or something.  Maybe this is baby's way of telling us it's not a good idea to attempt a vaginal delivery?  It's always a possibility.  

For now, we wait.  We've decided to do what we can (additional chiropractor visits with my Webster's trained doctor as well as more exercises, for what it's worth, I later called my provider back to see if a version is an option at this point and for me it is not) for this week and assuming labor doesn't start on its own I'll go to my 41 week visit where they'll check positioning again and then we'll reevaluate things at that time.  For now, I feel best letting baby decide what's happening.  I'll give her as much time as I can to allow her to turn (and do what I can to make that possible), but if I go into labor and she's still breech it's out of my hands at that point. 


3 comments:

  1. Stephanie, I'm so sorry to hear this! Facing a C-section again is scary and so not what what you wanted. I hope Molly(?) flips back around and comes to say hi soon and safely!

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  2. I'm really sorry you might lose your VBAC. I remember how devastated I was when I lost mine. That last appointment went almost exactly like yours except mine was due to size. My doctor even said she felt like crying too. My heart was just broken.

    I really hope she turns back this weekend, as long as it didn't happen for a reason. If not, I hope the surgery is smooth and easy and baby is a breastfeeding champ!

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