Tuesday, July 26, 2011

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!

Wednesday, July 13, 2011

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!