Well into the 3rd trimester...

It looks like it's been about 2 months since I have posted, so I am way overdue for an update! I am now well into my 3rd trimester at over 31 weeks and am feeling pretty good overall so far. I just recently started to feel that "uncomfortable" stage, especially at night as it is hard to get into a comfortable position. Usually this is how I feel the entire last month of pregnancy but this is starting a little bit early. I guess that goes with the territory when you are pregnant with your 4th child!

Of course I've been getting lots of the usual comments and questions that also goes with the territory... on our trip out to VA for Thanksgiving (yes, we drove 18 hours to VA with three small children and a pregnant woman, and we survived!!) an eldery man in the parking lot made a comment... he looked in our car and asked, "You've got three children back there, eh?" then looks at me and adds, "and you're expecting another? Have you figured out how that works yet?" I wanted to say, "No sir, could you please explain it to us so we can make it stop?!" Of course I just laughed and said, "Yeah, we've figured it out!" Everyone has an opinion... of course with the Duggars in the news lately, we get the questions about whether or not we are stopping at 4 or going for a record... I don't understand why 4 children is such a big number, but hey, maybe that's just me! For the record, no, we don't know if 4 is the magic number, only God knows that. Plus, a lot depends on whether or not I am successful with this VBAC. I want to believe with all my heart that I will be, but again, that's all in God's hands. Of course I am still continuing on with my preparations as much as possible. Unfortunately, things didn't work out with our Bradley classes... long story that I won't get into, but I am still preparing with Bradley methods by reading books and getting advice from my amazing, wonderful doula! She has been invaluable to us. If anyone is considering a natural birth, please, please, please hire a doula! You will never regret it!

Everything is progressing quite well with my OB visits and everything seems to be normal. Dr. C has always commented that the baby has a nice strong heartbeat and everything looks great. Now that I am in my 3rd trimester I am seeing him every 2 weeks, and then the last month I should be going weekly through my due date (and beyond if necessary!) Just so everyone knows, my "due date" is just an estimated date, not an expiration date... I have about 8 weeks until my due date, but I am fully prepared to go 2 weeks beyond that if needed. I want to give this baby every opportunity to show herself to the world when she is good and ready!

I have been reading several books in preparation for this birth. One of the books I just finished is by Henci Goer, called "The Thinking Woman's Guide to a Better Birth." I have to say this book is fabulous and a MUST read for every first time Mom who is pregnant or thinking of getting pregnant. I wish I had read this before having my first child! It actually made me a little angry as I read it and realized how UN-necessary my first c-section was! One thing I learned is that an epidural can cause a fever in the mother, especially if it has been in a long time. When I was induced with my first, they immediately gave me the epidural, and I didn't go into full labor for about 11 hours... so it was in for 11 hours and then once it came time for me to push, the epidural caused me to have a fever, which it was immediately assumed that I must have an infection if I have a fever, so straight to the OR I went. When in reality, it was probably just a side effect of the epidural and not an infection at all. I wish I had known that before!

I will post more soon, but I just wanted to give an update on how things are going. Happy to be in the homestretch!

Let's start with a dream

In my last update, I forgot to mention a dream I had recently that pretty much sums up this whole journey to VBAC experience so far. I had a dream that I was sent to the hospital for "observation." I wasn't in labor yet though. For some reason, my Doctor was not available to see me, so who did they put in his place? My old OB who did all 3 of my c-sections!! I kept saying over and over again, "But I'm not in labor, I need to go home!" She kept insisting that I stay and be monitored. She strapped me down and kept saying that I needed to have a c-section! I was sweating bullets trying to figure a way out of that hospital!! Somehow I escaped... but I woke up seriously freaking out!

I think that really does sum up what many women in my position are feeling when they start this journey of attempting a VBAC. I think we feel like there are so many obstacles to overcome, the biggest one being the medical community. I am NOT anti-hospital or Doctors... I plan to birth in a hospital with a Doctor. But I do feel that the medical community as a whole needs to wake up to the reality of what is going on around them. The c-section rate is climbing every day, and it is not out of necessity, it is out of convenience! The World Health Organization says that there should be no more than 15% c-sections if all c-sections were done out of absolute medical necessity... yet the numbers have climbed well over 30% in many hospitals, some reaching as high as 50-60%! That number is astronomical to me! Unfortunately, the hospital I delivered my first three children in had a very high c-section rate. I wish I had been armed with that information before heading into my first pregnancy. There is so much I wish I had known when I first started out! This is why I feel so strongly about sharing my experiences in hopes that it will help someone out there to make wise choices for themselves instead of Doctors making those choices for them.

So here are some of the things that I am doing to make sure I have the best possible chance of having a successful VBAC:

1. Find a supportive Doctor. I truly believe this is the most important thing you can possibly do! If this is your first time pregnant, you have to be diligent about researching Doctors, asking around for recommendations and ask tons of questions when you first meet that Doctor! Don't be afraid to ask questions! Find out what their induction and c-section rate is.. if they are hesitant to answer, run as far as you can!! If you are at all interested in having a natural birth, choose a hospital and Doctor that are known for being more "pro-natural." I think if I had to do this all over again, I would've also considered using a Midwife. I think either a Doctor or Midwife is a great choice, as long as they are not known for pushing inductions and c-sections. If you are pregnant after one or more c-sections, you MUST have a Doctor or Midwife that is pro-VBAC. Don't just take their word for it if they say "Oh yeah, I'll let you have a trial of labor and TRY for a VBAC." There is a good chance, they won't in the end. Sorry to be cynical, but this is just the plain truth. Find out from your local ICAN chapter which Doctors are pro-VBAC, and choose wisely. For me, I didn't have a choice. My Doctor is the ONLY Doctor in all of Texas and really all of most of the U.S. who will do a VBAC after 3 c-sections. He is only one of TWO Doctors in the U.S. who will do a VBAC after 4 c-sections. The other one is in the Atlanta area. We are blessed in the DFW area to have such a Doctor who believes in the woman's ability to birth naturally. So no, I didn't have a choice, but I couldn't be happier with that choice!

2. Hire a doula! I have already mentioned before about hiring a doula, but I can not stress enough how invaluable it is to have a doula! I haven't even been through the birthing process with her yet, but she has already well exceeded my expectations! She has just such a wealth of information available to give me anytime I have questions and is there anytime I have one either by email or phone. Having a doula can help to reduce the mother's request for an epidural or pain medication as well as reduces the need for pitocin or cesareans. (Read up about doulas on the website: http://www.dona.org/) My doula, Katie, has become a friend to me and I know that she will be even more invaluable to me once it comes time for the birthing process! I am SO thankful I found her!

3. Take birthing classes. Steve and I are currently taking Bradley classes and just started this week. It was pretty funny that we were the only couple that had children already, since most couples who take birthing classes are first time parents! I just feel so strongly that I need to be armed with as much information as possible in order to achieve a natural birth. The Bradley classes teach different exercises and relaxation techniques to help manage the pain of childbirth. I will be the first to admit that I am SCARED of the pain that I will experience during labor and delivery. But I feel that the Bradley techniques as well of the help of my doula (and husband!!) will get me through that pain. There are other birthing classes out there of course. Many doulas will offer shorter classes to give you an overview of some techniques to use. The standard Bradley class is 12 weeks long (ours is condensed into 8 weeks) and many people just don't have the time to put into that many weeks of classes. There are other options out there!

4. Brewer's diet. One of the things that Katie and my Bradley instructor have introduced me to is something called the Brewer's diet. It is a high protein diet for pregnant women which is supposed to significantly reduce the risk of pre-eclampsia, which is one of the biggest reasons for needing a c-section. You can learn more about the diet here: http://www.drbrewerpregnancydiet.com/index.html

5. Go see a Chiropractor who is Webster certified. I am still learning about this and am sold on the need for it, but am figuring out now if it is in the budget! I'm not sure if my insurance will cover it, so it may all depend on that. If anything, I hope to be able to go a couple of times (hopefully more) during my last trimester. There is something called the Webster technique (which you can read about here: http://www.icpa4kids.com/about/webster_technique.htm) that is done during pregnancy. I am not an expert on this by any means, but from what I understand, this helps facilitate optimal fetal positioning for birth. If you have a breech baby especially, this would be very helpful! According to Katie, it also helps to have a much easier delivery. A baby that is malpositioned can cause a much longer and harder delivery and often lead to a c-section. I have also heard from many other Moms that they swear by this as well and highly recommended doing it.

6. Have a birth plan! I think this is absolutely crucial. Even with such a supportive Doctor like mine, there is still the possibility that he will be out of town or unavailable when it comes time to deliver. Most Doctors would not even touch a woman who has had 3 c-sections and would automatically send me to a repeat c-section. Fortunately, my Doctor has several back up Doctors that are willing to go by the birth plan as long as Dr. C has signed off on it. You may have some battles to face, even with the birth plan, such as the hospital staff or an unwilling on-call Doctor. But it is so important to have your desires written down so that there is no question of what you expect to happen that day! If you have a doula, she can help you write a birth plan and let you know of some of the things you should put on it.

Those are just 6 things that I think are pretty important.. I know I have left off many. Unfortunately, as a VBAC hopeful, you have to go the extra mile, but hopefully, worth it in the end. I started with a dream with fears... I hope the end of that dream will be a happy ending with my beautiful baby girl delivered the way I desire it to happen! I do understand that there aren't always happy endings, but it won't be because I didn't try my hardest!

It's a....

GIRL!!! I went in for my 19 week appointment this week for my big gender ultrasound. Steve and I loaded up all three kiddos and made a family event out of it. The kids have been back and forth lately with boy vs. girl. I had a feeling it was a girl, but most of my family was convinced it was a boy. I think the Mom is usually right... after all, I am carrying this little one inside of me! When I first got a peek at the baby, I got all emotional, as this was the very first time I had even seen her on the screen. I never got an early ultrasound like I normally do. At first, I thought I saw a boy part... but then the ultrasound technician said, "It looks like you are having a girl!" Steve got all teary eyed, and the kids cheered! It was a beautiful moment! We couldn't be more excited to welcome our little girl into the family. God sure knew that we would need symmetry by evening out the genders in our family. Steve, being the math minded man that he is, couldn't be more thrilled! We are now finalizing our "S" name to keep in tradition with girls being "S" names and boys being "C" names. We are pretty certain we know the first name but are still agreeing on a middle name. Stay tuned....

Dr. C. then met with us briefly and said that everything looked good, except that my placenta was laying a little bit low. He wasn't concerned at this point, since he felt it was far enough away from the cervix that it should move up as I grow bigger. This happened to me in a previous pregnancy, and everything turned out fine. When I mentioned that our little girl was evening out the genders in our family, he said, "Well I don't think that makes your family complete." He said he thinks we should keep on going... I told him if I get this VBAC, we might just do that! He said "Well we will do everything we can to make that happen!" I LOVE this Doctor!

Right now I am deciding whether or not I should wean Caleb from breastfeeding. He just turned one and I am now at the half way point of my pregnancy. Typically at this point, my milk would be drying up, but it's not. He is perfectly content to continue and so am I. Really, I would miss it! So far I am continuing but will just wait and see if it affects my milk and if he decides he wants to wean. I have no interest in tandem feeding at this point (feeding both him and the baby at the same time) so I may just try to wean him by December.

All in all, everything is going well. I am happy with my weight gain and am feeling regular movement. I will post new belly pics soon!

Well hello there 2nd trimester!

Well I am officially in the 2nd trimester, and actually already a week into it, as I am 15 weeks today! Hard to believe... it's flown by so fast! In the past 4 weeks I have seen Dr. C twice to confirm that everything was A-ok with my uterus. Fortunately there were no ER trips for me this time around... although a couple of times I was a little bit nervous in the middle of the night that it might be happening. Fortunately I was armed with my exercises to push the uterus back out, and it seemed to help. As of today, the uterus has completely lifted up and there is no more worry there... we have heard the baby's heartbeat several times now... all three times it has ranged from 150's to 160's. Today it was 168. Dr. C. asked me if I had a feeling if it was a boy or girl. I told him sort of have a feeling it's a girl... but hey, I guess I have a 50% chance I'm right, huh? He laughed and said yes! But we will officially find out that news in 4 weeks! I am so excited to find out! The kids keep going back and forth between saying it's a girl and boy. I guess we will find out soon enough!

Pretty soon we will be shopping for the much needed mini-van to make our growing family official...

In VBAC news, I have joined the ICAN of North Texas group... ICAN is the International Cesarean Awareness Network, which naturally, raises awareness about cesareans, and promotes VBACs. It's a wonderful group of women who encourage each other during the process of attempting a VBAC, or post-cesarean. I have also officially hired a Doula and am very excited to be working with her. And last but not least, I signed up for my Bradley classes, which start on October 3rd. After sending in the deposits for both my Doula and Bradley classes, I had this moment of panic... realizing, this is really happening! I am really attempting a VBAC after 3 cesareans and *gasp* attempting a NATURAL birth! I know I can do this, but it was the moment of truth for me. I am pushing forward, full steam ahead.

Doctors and Doulas

I am just beginning week 12. Last monday I had my first official appointment with my new Doctor. All went well. Standard first visit... drew blood, took blood pressure, got weighed (ugh, gained a few lbs), had a PAP and pelvic exam. But then, the lovely news... some of you may know about my uterus issues. Well I have a severely retroverted uterus. It tilts back so far that it can get me into trouble when I'm pregnant. With my first pregnancy, I was about 13 weeks along, and in the middle of the night I woke up and discovered that I could not go to the bathroom! I had a full bladder but nothing was happening. I spent two hours trying to go, but couldn't. Finally, in absolute agony, I woke up my husband and we called the on call Doctor. He told me to go straight to the ER to get a catheter. This was my first joyous experience of having a catheter, and certainly not the last. When my Doctor's office opened that morning I went in to see her and found out about my retroverted uterus. I didn't even know I had one! Turns out it's common to have one, but NOT common to have it so bad that it can block off urination. I was the first patient of my Doctor to have this happen! She tried to manually flip my uterus back into place. She thought she got it, and sent me on my way. The next night, my 30th birthday... I ended up in the ER again. :( Another catheter, and then went back to see my Doctor again. This time she called in the enforcements. She called in her colleague, an older Doctor who had seen TWO patients in his 25 or so years as a Doctor with my condition. So he knew... a little more than she did! They both tried to manually flip it again. This time it was so stuck it was soooo painful that I felt like I was already experiencing childbirth. So they decided that the next day I would need to come into the OR to be put to sleep and have them flip it while I couldn't feel what they were doing! End of story, my uterus was flipped and all was well.

Well... Dr. C checked for the position of my uterus, and turns out ol' faithful is not cooperating again. He said it is so low that he expects it to happen again, just like it did with my first pregnancy. Normally at this stage of pregnancy, I would be going to see my Doctor every 4 weeks, but he asked that I come back in 2 weeks to stay on top of the uterus issues. In 2 weeks from that date, I would be 13 weeks, which is the exact time that it happened with my first pregnancy, and he didn't want it to be too late. Since I hadn't had a sono yet to check for a heartbeat, Dr. C. said we would try to listen for it on the doppler, since an internal sono would be a little too painful right now considering my "condition." We didn't really expect to hear anything, as I had NEVER heard the heartbeat on a doppler before 14 weeks with my prior Doctor, because my uterus is so far back. He moved it around a bit, but was only picking up my heartbeat. But then he got it low enough... and voila, there was the baby's heartbeat! I seriously think this man is a genius! So I felt much better about not having a sono, and went on my way.

On Saturday of this past week, I met with a potential Doula. The word Doula comes from the Greek word for "female slave." She wouldn't quite be my slave, but she would be my "labor companion." She isn't supposed to take the place of my husband, but rather be a support to both of us during labor. She will come to my home once I go into active labor and help me through breathing until it is time to go to the hospital. She doesn't provide medical support, but is able to tell when it is best to go to the hospital. The use of a Doula strongly increases your chance of having a natural, vaginal delivery. She is able to help fight for your rights at the hospital if they are trying to push things like epidurals or c-sections before it is absolutely necessary. I absolutely loved this woman, and will most likely be using her for my delivery! The exciting thing is, she also had a VBA3C (VBAC after 3 c-sections) with Dr. C, so she is strongly connected to my particular situation! I am looking forward to working with her! She is also a Christian, and that is really important to me.

So now I have entered my 12th week. So far I am not sure how things are going with my uterus. There have been a couple of nights where I questioned whether or not it was happening again. I think if it happens again tonight, I may be calling my Doctor tomorrow. If not, we'll see what happens on Monday the 1st when I go back in for my next appointment!

And so the journey begins...

My story:

When I was pregnant with my first child, I was young and naiive. I really didn't know anything about childbirth. I knew it was supposed to be painful. I assumed that everything would go exactly like it does in the movies, my water would break unexpectedly several days before my due date, and I would be rushed to the hospital, pop in the epidural, and then smooth sailing from there! It didn't exactly go as planned. With my first pregnancy, I was very over weight, I will admit. I started off over weight, and gained over 50 lbs throughout the pregnancy. My legs and ankles were swollen all day long, and I was absolutely miserable. About a week before my "due date", I developed a rash on my stomach that I later learned was called PUPPS, which is an awful pregnancy related rash similar to hives that makes you just absolutely miserable. So here I am, over weight, rash all over my stomach and my ankles were the size of elephants. My last OB appointment before my "due date" was scheduled for 3 days prior and I was absolutely convinced that I was not going to leave that appointment without being told I was about to have my baby. I packed my bags and brought them with me!

My OB took one look at me and saw the misery in my eyes. She took my blood pressure, and it was slightly elevated. She told me she doesn't normally induce first time mothers until at least a week past due, but felt that this would be a reason to induce. I almost jumped out of the table to hug her! We did a sono, and sure enough, the baby was measuring "big" and that just sealed the deal for her. I was immediately taken over to L&D to stay the night and be induced first thing in the morning. First thing in the morning: induced, epidural, wait. I waited all day long. Contractions were showing on the monitor, but I couldn't feel it, I had my happy juice. Every time I was checked, there was no progress. I didn't progress past 4 cm all day. Around 4 pm, my OB came and checked me, and started talking about a c-section. She said she would be back in an hour, and if I hadn't progressed, we would move forward. I of course was devastated. 20 minutes later, I began to shake uncontrollably. My sweet husband went to get the nurse. She came in, checked me, and said that I was dilated to a 10 and ready to push! So we began to push. We kept pushing and pushing. I was told to push harder, but I certainly couldn't feel whether or not I was pushing hard because I had that epidural! I was so exhausted from pushing, and had absolutely nothing to show for it. My OB came to help and still no progress. After 90 minutes of pushing, I began to feel sick, turns out I had a fever which meant I had developed an infection. Baby's heart rate went over 200! So immediately I was wheeled into the OR and ended up with a c-section.

When I became pregnant with baby #2, I assumed I would need to have another c-section. But then I began to do my research and learned about VBACs. I knew what they were, I am a product of one. For those who don't know, a VBAC is a Vaginal Birth after Caesarean. My sweet mother delivered her first child by c-section and then delivered myself and my brother naturally. But I had never really given it much thought. I brought the idea to my OB and asked her if she would consider it. She said she would! She told me the risks involved and said that if I would like to try, she would support me. The risks are really very small, about 0.55% that something could go wrong, typically uterine rupture. But even then if that happens, the chances of it becoming fatal are even smaller. So I decided to move forward. Unfortunately, I was still pretty naiive. I didn't do much research beyond what a VBAC was and that it really wasn't as risky as people make it out to be. I didn't look into the idea of trying natural birth and I certainly didn't know that many Doctors will act supportive in the beginning and then pull the plug a little too soon. Well that is exactly what happened. Two days before my due date, I took my blood pressure and it was "slightly elevated." It wasn't considered high, just on the cusp over being normal. So I reluctantly called my OB and she asked me to come in. The nurse took my blood pressure, and like me, thought it wasn't too high and didn't see it as being cause for concern. I went in the waiting room and then my OB came in and said, "Guess who is having a baby today?" Well I certainly didn't think it would be me! I had no signs of labor coming on, and my blood pressure really wasn't all that high. But no, she was convinced that the elevated blood pressure meant I needed to immediately go in for a c-section. I was devastated, again.

Baby #3 on the way, and even though I entertained ideas of VBAC again in my head, I knew it was probably a lost cause. My thoughts were confirmed when I met with my OB and she said, "Well you don't get a choice this time, we will do a repeat caesarean." I caved. Even though I had people telling me that some Doctors will consider a VBAC after two caesareans, I just didn't want to think about changing Doctors at this point. Even though I didn't agree totally with how she handled everything with my attempt to VBAC, I still really loved her as a Doctor. I enjoyed working with her, and well, I just didn't want to rock the boat. So I had my third c-section.

With #2 and #3 I developed an awful incision infection that had to be treated with an antibiotic. C-sections mean a much longer recovery process. I was already hurting, let alone having to deal with an infection. With #3, I also developed PPD (postpartum depression.) I really do feel a lot of that had to do with how I was feeling with my long recovery. After several months of dealing with the depression, I was finally feeling back to normal. But I in no way, was ready to even think about having another child. I even told my husband I wasn't sure if I wanted to have any more kids. I didn't want to think about having another surgery, and I was overwhelmed with life in general.

But then it happened, blessing #4. I was not expecting this at all. We weren't physically preventing, but we were taking ovulation tests to make sure I wasn't ovulating... well, I guess it didn't work. I was about 10 days late, and really didn't think anything of it, because my cycles have been whacky since my period returned. I was still nursing my almost 10 month old and it just hadn't dawned on me that I was "late." So I randomly took a pregnancy test one day, thinking I would just confirm that my period was still just being weird. I got an immediate dark positive! Holy cow, we're doing this again!

Immediately, the terror set in. I don't want to go under the knife again! I told my husband that this was it for sure, I was getting my tubes tied, I could not handle another surgery after this. He told me we would pray about it, but let's just take this one step at a time. Then the thoughts began to come back... what about a VBAC? No that's crazy, I thought. What Doctor in their right mind would even consider that after three c-sections! Some, very few, will consider after two, but after THREE?? No way. I certainly knew my Doctor wouldn't! But I just felt this nudging inside to look into it. I began to google Doctors in the Dallas area that specialize in VBAC. One name in particular kept coming up. It was VBS week at church, and one of the women in the nursing room with me had mentioned her Doctor's name the day before. It was this VBAC Doctor! So the next day, the last day of VBS, I decided that if she and I were in the nursing room again at the same time, I would ask her about him. Sure enough, she was there. So I asked her, and she said he was not only fabulous, but she had a VBAC with him! She said that he is a wonderful Christian Doctor and was so worth talking to about the possibility. I told her I would pray about it. We went on vacation that week, and it was all I could think about. When I got home, I began to ask around some more. I asked my close friend who had just had a VBAC a couple months prior, and she asked her Doula for recommendations. She came back with the same name of this Doctor! She said that this Doctor was the ONLY Doctor in all of the Dallas area who would do a VBAC after 3 c-sections. Most Doctors limited it to two c-sections prior. Then another friend of mine asked around on Facebook for me, and came back with the same recommendation. So I knew I had to at least meet this man!

We scheduled the appointment and went in to meet with Dr. C. From the moment I met him, I felt at peace. I knew he was the one. When he looked over my operative reports and told me that he saw no reason why I couldn't try for a VBAC, I wanted to jump up and hug him! He said that he has always practiced with the belief that EVERY woman should have the opportunity to deliver vaginally, no matter how many c-sections she has had. I asked him why more Doctors wouldn't consider doing this, even though the research clearly shows it is safe. He said it basically boils down to convenience. I am not here to bash the medical community, but I do believe this to be very true. More and more Doctors today are scheduling c-sections, purely out of convenience for their schedule. Women every day are told that c-sections are just as safe if not safer than vaginal delivery. How could that possibly be true? It's major surgery!!

So now I embark on a whole new adventure. In future posts, I will share more details about VBACs, the risks, the facts. But for now I wanted to share my story as I begin the journey.

I feel like I have a new lease on life. I am so inspired and excited about this new adventure! I am seriously considering try to delivery "natural" as well! Thank you for reading my story, and look forward to sharing the journey ahead!