Friday, March 27, 2009

To VBAC or not to VBAC....

Has anyone out there actually had a VBAC (Vaginal Birth After Cesarean)? Let's just say my hopes of having a somewhat natural birth were shattered when I had my first in 2004. I had to have an emergency C-Section because I had developed severe Pre-Eclampsia and HELLP Syndrome. They took me in to be induced at 10 pm the night before and since my plateletes were dropping so fast and I hadn't progressed past a 1 1/2 they put my to sleep and cut me open at 9:29 am. Needless to say I was a little disappointed but I understood because I was on the verge of death....

Now almost 5 years later I am pregnant again and when I went to my first OB appointment I had to see the Nurse Practitioner. She just casually mentions that since I had a C-Section before that they will schedule me for another a week before my due date and take it then. You read and hear about VBAC's all the time and in fact we studied them in nursing school. There is a small risk of uterine rupture with a VBAC. one website said it was 5 in every 1000 who attempted and another site said 27 in 10,000 attempted will rupture and 1.4 in 10,000 will end in fetal death. That is a small chance, there is a small chance of something happening with C-section even... nothing is guaranteed. The risk of rupture does increase though if cytotec is used to start or strengthen labor. I'm aware of the risks associated with it but there are risks also to the mom if a C-section is performed and the recovery isn't as smooth. I was in the hospital for 4 nights and I wasn't up and around even at the house for about 2 weeks after delivery.

Here's my argument. Most doctors want to do a repeat C-section because it is just more convenient for everyone... That is fine schedule me for a week before my due date to do it, but if I actually go into labor on my own, just let me do it and monitor me. I'm not saying induce me, we all see I didn't progress before, of course when they gave me the stuff to soften my cervix it hyperstimulated my uterus and I was having contractions every minute. The do say pitocin has rarely been linked to increasing the risk of uterine rupture. So augmenting your labor once it starts is OK. I've done my research. Who knows I may not even go into labor on my own but I really would like to do it naturally even with a few pain shots....

I feel like I missed out on the experience and I want to be able to bond with my little one sooner and not be in a daze for days. They had me on so many drugs that I don't remember much of the first few days. I wasn't able to see my daughter and hold her for at least 7 hours after she was born and I really don't remember. People that came to visit, I thought had never been there and asked why they didn't come. You might think I'm crazier than what you already do but I actually thought I had a baby still inside of me afterwards because I was so out of it and I had horrific pain in my abdomen because there was trapped gas. It felt like the baby was trying to kick it's way out when in fact there was nothing but trapped gas in there. I actually thought my daughter wasn't mine because she was so tiny and premie looking at only 4 lbs. 9 oz. I was only 2 1/2 weeks early and they thought the baby would be about 6 lbs. from the ultrasound but BOY was someone wrong. In my delirium I thought someone had mixed up the babies too! Glad I didn't push that issue, I would of looked crazy.

Overall I had a bad first birthing experience and most of the day nurses were horrible.... Most acted like I was an inconvenience which was not right. The night nurses however were great, they would bring me midnight snacks :) The one nurse that really got me though was the next day when she brought the baby in to start breastfeeding. She should have realized that I was still on certain meds like morphine and even Mag Sulfate and in fact you have to be off the Mag at least 24 hours before feeding because they don't want them to get too sleepy and out of it like I was. I am just so grateful the baby didn't want to feed, I think she intuitively knew (she's a genius) even at the ripe age of 1 day. I knew no better at the time so I just went with the nurse trying to feed. Later I found out when they brought the pump to me so I could try to produce until I was able to actually feed. Stupid Nurses. I think that is what actually drove me to go to Nursing School because I thought I could do better. I thought I could make a difference. Little did I know that one semester shy (already finished 3 out of 4) of graduating I would leave the program but I finally determined it wasn't for me. I did highly excel in OB/Maternity and the Reproduction part. That was the most part I was interested in. I've always wanted to be a nurse at the OB clinic. I can still get my LPN license though because I finished 3 semsters who knows I may decide to go for it. I would need to refresh a little though. Or maybe I could start as a PCA initially to see how I like it.

4 comments:

NursingBirth said...

I am a labor & delivery nurse who works at a high-risk hospital in the northeast. I would first like to say that I am really sorry your first birth experience was the way it was. Preeclampsia and HELLP are very serious and VERY scary for all those involved. However, sounds like your NP was right, from the limited knowledge you have provided, you do seem to be a great candidate for VBAC. I just posted a beautiful story on my blog about a patient I recently took care of who had a successful VBAC. If you are looking for some inspiration check it out!! www.nursingbirth.com

Also, I know that you said you have "already done your research" but if you haven't yet visited the ICAN (International Cesarean Awareness Network) and Childbirth Connection website, they are a GREAT resource for mom's thinking about a VBAC. Hopes this helps!!

Good Luck!
~Melissa
www.nursingbirth.com

Amanda said...

Keep doing your research until the very end of your pregnancy. I'm pretty sure when you get towards the end your mind and your body will let you decide what is right for you and not convienient for the doctors or nurses. SCREW THEM ALL!!!

Whatever you do, don't do pitocin. I HATED IT!!! It made my contractions feel so much worse than when I was off of it, and Mara did not react well with the constant stress of the contractions, because her heart rate dropped. They took me off of the pitocin and I didn't have any more problems with her heart rate dropping. Let your body do what is natural and let it go at its own pace.

As far as pain meds, I had no problems with wooziness with the epidural. Of course my epidural quit working.

Didn't the mag sulfate suck? I was on it forever (from Sunday at 7 pm until Tuesday at 11:00 am). Stupid me didn't eat anything all day before I went to the hospital because I didn't realize that I had to wait 24 hours after Mara was born before I could eat or drink anything. I was starving before they let me eat, and after only being alowed a small cup of ice chips about once every three hours, I was never more relieved then being alowed to drink some water. Not only that, when they started me on the mag sulfate, I felt all warm and flushed. I felt so totally weird. I really am surprised sometimes that Mara did not come out all screwed up, considering the pitocin, mag sulfate, and the epidural plus all the pain meds they kept pushing in me when the epidural quit. All that crap can not be good for a person or the baby. No wonder you want to keep it as natural as possible.

NursingBirth said...

Unfortunately I am not currently located in OK/AR area!! I totally understand feeling comfortable with your current OBGYNs. But as the post above say, don't stop researching until the very end!! I will send "good delivery vibes" your way no matter how you end up delivering your baby. Just remember that in the end it is YOU who is doing the delivering, not the OBGYN :) Good Luck! (Oh one more thing...have you seen the documentary "Business of Being Born"? If not, I highyly recommend it. If you have Netflix, put it on your list :)

~Melissa
www.nursingbirth.com

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