Sunday, November 27, 2011

?? Weeks

Please ignore my ridiculous hair in this picture. I didn't document my pregnancy with Madelyn very well and really wish I had (sorry kiddo) so I am attempting to do a better job this time around. I also am going to be doing a lot more research on VBAC and various birthing options so I intend to use this space as a place to sort my thoughts and possibly help someone else.

Pregnancy #2 so far:

1. Tougher with a mobile Madelyn at home already. I forgot how tired you are in the first trimester and there is no napping this time around. Nick has definitely stepped up and started taking Miss. M when he gets home from work. Even 30 minutes of being able to veg on the couch does wonders for my energy. I am pretty much following Madelyn to bed at night but oh well.

2. I'm predicting boy with this one. I know I said I thought Madelyn was a boy but that was because I wanted a girl so badly that I figured I would end up with a boy. To be honest, I never had a gut feeling with her. This one, I do. I just feel boy. That, and I feel nauseous which wasn't the case with M so maybe there's a little man swimming around in there. I can 100% say, I don't care if this baby is a boy or girl. And I don't even kind of have my fingers crossed one way or the other.

3. We are looking at alternative birthing options. I fully believe I was destined to fail when I walked into UofM 10 months ago. I believed my body would know what to do and that I would be strong enough to refuse all the medical interventions but 2 days of labor and not sleeping got to me and I ended up caving. I also fully believe, I will have to fight every step of the way in that hospital to VBAC with this baby. What does that leave us with? Birthing centers, a different hospital and home birth or a different avenue at UofM.

From what I have read, the #1 priority for those having successful VBACs was finding a supportive provider. Here is my beef with hospitals. Everyone has adopted this "team" approach with their pregnant patients. You will see one doctor throughout your pregnancy but then when you head into the hospital, your birth will be attended by one of the "team". Well your provider may be on board with a VBAC but who is to say the doctor on duty that day will feel the same way. The doctor who performed my c-section was ready to cut me open from the second she started her shift. I had never met her before and had no idea on her philosophies on birth. I believe, these issues will become even more apparant with a VBAC baby. The medical community is so split on this issue. This seems to be my biggest hang up with delivering at a hospital.

A big recommendation when delivering at a hospital and being a VBAC candidate is to labor at home as long as possible and then show up pushing. You can hire a doula to help keep you at home longer or even a monitrice who has the ability to check you to see how dialated you. My concern here is that a lot of uterine ruptures occur during labor, not during pushing. The best way to monitor for a rupture is to monitor the fetal heartrate. If I am at home for all of my labor, I'm not monitoring the baby's heartrate during that time. At least, I don't think a doula does that.

I like the idea of a birthing center. I don't like that the closest birthing center that does VBACs is over an hour away, in Okemos. I hated the 10 minute car ride to UofM last time, I can't see myself handling a hour+ car ride to Okemos. This left me wondering, how is it Ann Arbor doesn't have a freestanding birth center?

Last option is home birth. I keep going back and forth on this one. The only reason I would consider a home birth is because we live so close to UofM. In actuality, we are closer to the hospital at home than we would be if we went to the birth center in Okemos. I know all the numbers on safety of home birth and the risks as well as the safety and risks of a second c-section. Generally speaking, a c-section is safer for baby but not safer for mom. A VBAC is safer for mom but not safer for baby. In all of my research I came across a forum for VBAC moms and one lady was saying she opted for a VBAC because although it would break her heart to deal with the loss of a child, she couldn't imagine putting her first child through losing a mother. For some reason, this really stuck with me. I also hesitate to use the word "safer" because all this really relates to is mortality rates and we are also playing around with tenths of tenths of percents. In both scenarios the mortality rate is about 0.04%. However, when you take into account other risk factors such as blood loss and infection for mom as well as breathing problems for baby the idea of repeat c-section is not appealing to me.

Anyway, after that rambling trail of thought I come back to this. Although I know home birth is generally considered safe and in some circles it is considered safer than hospital birth, I can't seem to shake the what if scenario that creeps into my head.

At this point, Nick and I are planning on continuing care with the Taubman team that I saw during my pregnancy with Madelyn until we decide which route to go. We visited the birth center in Okemos and although we loved them, we ruled them out due to the distance. I have emailed several midwives in the surrounding area to interview them regarding home birth as well as set up an initial interview with a midwife the practices at UofM.

More to come....

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