VBAAM vs. C-section

It seems my plight is ending regarding seeking out second opinions regarding a Vaginal Birth After Abdominal Myomectomy (VBAAM). I have sent out five faxes to Obs and physicians in the area along with numerous emails to online doctors, midwives and doulas. Initially the OBs that I sent my letter and operative report too, gave me the same answer as my current OB office…no vaginal birth. So I figured that I better seek out the advice of some midwives since the OBs may have some contractual or liability issues that were standing in the way of them making an objective recommendation. I emailed a doula in my area who referred me to a physician that she said had allowed a woman in my situation with uterine scar at same fundal height to labor, however in the end she need a c-section. That physician and his partner stated that based on my operative report, they agreed that I should have a c-section. Still not convinced, I gleaned some information from the worthwile blog and found a wonderful midwife by the name of Elizabeth Stein who has written some articles on VBAC among other things. I sent her a fax with my information on yesterday and low and behold she called me this morning to discuss. She said ‘You may not like what I am about to say, but I recommend c-section based on what I have read in your operative report’. I told her that I really needed to hear it from a midwife instead of an OB because I know that midwives are more in tune with women’s needs and are more willing to do what OBs are not willing to because they are more concerned about liability issues etc. We chatted for about 5 minutes and she gave me some stories of VBAC births and the outcomes…one of which she spoke about a woman that labored but required c-section and they went in only to find the baby peaking back out at them through a hole in her uterus. That one sent me for a loop. All in all I trust her opinion more than anyone else, like I said I think it is because she is a midwife and I’ve read up on some articles she has written. I do still need to hear from two other doctors, one that a doula referred me to and the other is a mid-wife clinic in my area, but as of now I am focusing my energy more on planning a natural c-section and working with a doula to prepare for this event.

Either way I know I want a doula in the room to reassure both me and my hubbie of what is going on. After my myomectomy he was terrified seeing me laid up like that and he is still terrified. I need to get a handle on this so I can help comfort him and let him know that everything is going to be fine. I started researching this natural c-section birth and really like the idea of it. I also learned that I can have epidural anesthesia is I have a planned c-section instead of an emergency one. In epidural they will just numb the area that they’ll be cutting in so that I can’t feel it, but in general anesthesia I would be drugged up and unable to enjoy any part of the birth. I found a wonderful c-section plan at the ICAN site that had a wealth of information regarding the best way to plan a section. So, I am going to begin to focus my energy on this.

After reading those sites, I realize a c-section does not have to be as primitive looking as it once was. I imagined myself completely doped up on the table, Mr. Butterbean Sr. completely terrified as they cut me out and rip my baby out in a matter of seconds, then wisk her off to be checked, poked and prodded while I never get to hold her until I get back to my room and at that point I am too doped up to even hold her or remember anything that has happened. I don’t want that. But now I’ve learned that it does not have to be this way at all. I am still a bit skeptical about how I will care for my baby while trying to heal up, but in the end it may be my only option and I’ll just have to make do.

Having done all the research makes it much easier for me to accept rather than just being told what I have to do with my body. Now I feel it is truly my decision and I am making an informed one…that makes all the difference in the world.

Assisted Cesarean Sections

I came across this article on assisted c-section while I was doing my research and exploring my options.

I thought it was totally amazing how the mother actually pulled the baby out of her womb herself. She was the first to touch her baby. Most c-section stories I hear about have the mom all drugged up and dizzy and unaware of what is going on.

If I have to have a c-section I am opting for epidural anethesia and a certified doula!

Week 24, Day 1

Hello Blogosphere! I am still here trekking along with Lil’ Butterbean in tow. I am officially 6 months pregnant today and can’t believe how the time has flown. It seems like I lost track from week 19 to now!

As of now I am still researching Vaginal Birth After Abdominal Myomectomy (VBAAM...I am going to copyright/trademark this term, seems I might be the first to use it!) and fighting my OB clinic to allow me to attempt a trial of labor or at least go into labor before they try to cut my baby out of me. I have an appointment on Thursday and will be firing off tons of questions. I hope they are ready.

There is definitely NOT enough information on the website regarding VBAAM and I consider myself to be one of the most thorough researchers I know. LOL!!! There have been two sites that have helped me a bit more. The most informative one spoke specifically to incisions into the uterus at varying heights and styles. One at the same fundal height as my own. The other is a Q&A site I stumbled upon by chance. I was able to email the expert and got a quick response from her regarding my concerns. I have also spoken to a very knowledgeable doula in my area who referred me to a couple of doctors and supports my desire to keep my baby inside until she is ready to come out (up to 42 weeks) and to allow me to attempt the trial of labor or at least go into labor naturally without having a planned c-section. Mid-May I am going to a seminar at a mid-wife clinic in my area. I have also faxed a few doctors for their opinions. All in all I feel I am doing the best possible thing for me and my little one.

I am not saying that I want to do a trial of labor come hell or high water regardless of the threat to my and my baby’s life. I am saying I want to do what’s best for all of us. I want to go into labor naturally and not plan a date to have her evicted. I want to be monitored and make informed decisions regarding the best path. In the end I may need the c-section but let it not be a decision made now. I am in the thick of it all and the risks began the moment I conceived. God’s will shall be done and He will give me the answers.

In regards to other things, Lil’ Butterbean decided to pop and show and there is no hiding the fact that I am pregnant. I am still small and I think she will be a small baby but as long as she is healthy I am happy. She is active and I have learned her daily patterns. She has learned her daddy’s voice and gets excited when she hears him speaking. The other morning I put his hand on my tummy so he could feel her kicking around. She gave him some very strong kicks and he was amazed at how hard they were. It was so cute. I told him ‘she is saying, get up and eat!’

I noticed I am beginning to retain water and the salt in my diet is not helping. My nose has taken a turn for the worse and begin to spread a bit and my breasts are DEFINITELY going through some changes. I am at the point that I need to buy a bigger bra, I made it all the way to 6 months before needing this! My skin was also acting up, but the high grease diet can also be blamed for that.

I am now getting a grip on myself. It has been so nice having an appetite after not wanting to eat and barely being able to eat. I can eat now, but still in small portions and I’ve indulged enough. I have not drank enough water. Now its time for walking and toning to get me ready for labor along with some healthier eating so I don’t have to break bad habits immediately after I deliver. I have only gained 7 pounds but since I was overweight to begin with, I am not worried about that. I think it’d be fantastic to drop 15-20 pounds and come out of the pregnancy at a lower weight than I went in. Then again we’ve got 16 weeks to go and anything can happen. LOL!! Overall, I am totally enjoying this pregnancy thing.

Week 22, Day 2

Five and a half months pregnant. Wow! Time seems to be picking up speed and flying by. Nothing that new to discuss expect at my last doctor’s visit the physician informed me that the practice voted a big fat no for me even attempting a vaginal birth after myomectomy. I have researched this topic at length and not found much information as should be available concerning it. I went to the fibroid geek site that I am a member of and found one woman after another saying ‘my doctor said I’ll have to have a c-section’. Well that’s what mine says too but I say I am in control of my own body and I will make my own decisions. The last doctor explained the situation to me in MUCH greater detail and even gave me a copy of the post op report from the doctor who performed the myomectomy as well as some referrals for other doctors since I told him I was going to get some other opinions. Granted he has 28 years of experience and that’s nothing to thumb your nose at, but still I feel as though there has to be other considerations. He said since my cut was on the fundus and so large (I had an 11 cm fibroid) that went all the way down to the soft pouch of the uterus, that there was just NO WAY! He said that my incision is on the working part of the uterus that is really working to push the baby down and out and therefore there was too great a risk of uterine rupture. He said vaginal birth may be better for me, but c-section is best for the baby. This rubbed me the wrong way and I laid into him telling him that I will do what is best for my baby. Somehow I don’t think cutting her out of me 2 weeks early is the right thing for her. I also need to be able to care for this very same baby once we get home and after being sliced once, I know what that was like and I simply could not imagine having to care for a small baby along with it. On top of that I want to give her siblings too and the constant slicing and dicing on my uterus is definitely not good for that.

All in all I am still researching and will be visiting 2 other doctors offices to see what they have to say. I will also research some midwives and doulahs to see what I can find. I am not 100% against c-section, I just think they should allow me to go into labor naturally and monitor to see how its going. From most reports uterine rupture occurs prior to deliver as late as 33 weeks. On top of that, if the doctors are so concerned about uterine rupture, I wonder what they’ll be doing to monitor me? More frequent u/s to monitor the uterus? What. I’ve got lots of questions for them and they better be prepared to answer and answer well!

I know it may seem like I am being ungrateful after my struggle with infertility, but I also do not think I am supposed to just ‘lay down and take’ whatever the doctors dish out. I think God works miracles and I have been put in this situation to show others how he works. I’ve prayed over this entire pregnancy and know that God is in control. He is on it and I told him I’ll get the info and wait on a word from Him. So far I think my little girl will be a small baby and I do believe that is a blessing so her size does not put too much stress on my mended uterus. I’ve gained 6 pounds total and I think I probably loss a good bit initially, so I am doing well. God will let me know what to do for sure!

On another note my baby girl is moving around and her kicks are stronger and stronger. I hum to her and sing and she even reacts to her daddy’s voice now. Its so cute and I am so very happy and blessed!