2.11.2007

10 Weeks, 3 Days

Well, we did it. We thought maybe it was time for another kiddo, with the pooper getting nearer to 2 yrs old, and the very first month that we tried, Bingo! We weren't going to try until January, after we got back from the New Year's / DH's 40th birthday celebration in Paris (because who in their right mind would try to get pregnant right before a trip to Paris), but in mid-December I was siezed by the thought that this kiddo wanted to be a September baby and wanted to get here now. So into the sack we hopped. Funny thing is, we conceived the night of Dec. 14, after the lousy City Council meeting where they decided not to revoke the site plan or even to consider any action on it at all. As another volunteer said, at least something worked out right that night.

So for the last 4 weeks and three days I have been queasy, tired, moody, and waking up in the middle of the night to pee. I thought that didn't happen until the end of the last trimester? Part of me can't believe that I've voluntarily opted to put myself - and us - through all of this again. Having the pooper was wonderful, but the end of the pregnancy and his first few months were brutal, and I'm dreading going through that period again. My mom assures me that we had an especially hard time with the pooper and the next kid will be easier, but as another friend evenly reminded me, it could also be worse. Pooper was delivered by scheduled c-section, 9 days post-due date at 9 lbs. 4 oz. We didn't even try to induce because statistically it was more likely than not that I'd end up going in for a c-section, given the timing and his size and also the fact that my body had not even started to get a clue about transitioning from pregnancy to birth - cervix was high and firm, baby hadn't dropped - nada.

Supposedly a scheduled c/s is much easier to recover from because you aren't going into surgery exhausted and dehydrated. Not so for me. It was months before I started to feel okay in my body again. For weeks I could only nurse sitting up with baby propped beside me because the weight of his body on my abdomen was too much - which meant hauling a bunch of pillows around the house with me all day long and no nighttime side-lying nursing. And our poor little guy had severe acid reflux and, even after getting treatment to keep him more comfortable, never napped for more than 30 minutes at a time. He was a darling baby and was smiling by 2 weeks, but I still also remember being nearly catatonic with physical and emotional exhaustion during that time. So as excited as I am about bringing the pooper his little brother or sister, I'm also dreading the first few months.

I'm also having to find another ob/gyn. My original doctor, at my 8 week appointment, said, "so we're going to schedule you for a c-section, right?" Excuse me, doc? He then went on to explain that delivering VBAC was very risky, that there was a 1/100 chance I would experience a uterine rupture, and then even with an anaesthesiologist, surgeon and nurses by my side, there might be nothing that they could do in time and the baby would be brain damaged and possibly die. Technically, this isn't far from the truth, but the risk picture is very different from the way he has depicted it. A 2004 Kaiser study of close to 18,000 VBAC births found a uterine rupture rate of 0.7%, and of those that experienced a uterine rupture, about 5.5% resulted in brain damage to the baby, which comes out to an overall risk of brain damage from uterine rupture in a VBAC to about 1/2,550. Plus, in the study sample, there was no control for whether the VBAC patients were administered pitocin during their labor, which is significant because pitocin is known to increase the risk for uterine rupture - by up to 10x according to some sources. It's not unreasonable, therefore, to infer that the rate of uterine rupture for a natural childbirth would be even lower than the 0.7% found in the Kaiser study.

I don't want to stay with my current ob just to have him tolerate this silly notion I have that I'll deliver naturally, if at all possible, just to have him tell me at 36 weeks that I need to find another doctor if I'm still determined to try for a VBAC (which this doctor has done before to another patient). It may be that I do end up with a second c/s, but I need to know that I arrived there for the right reasons, not just because my dr. is a fan of c/s. I have my first interview with another ob next Tuesday, and I'm really looking forward to meeting her. I hear that she's also going to law school now, so I'm a little concerned about her availability, but we'll discuss that along with everything else. She's generously given me an appointment slot to chat without charging me for the appointment, which is a good sign. I have two pages of typed questions to go over with her, so I'll make the best use of my 15 minutes possible.

This morning I realized as I lay in bed on my back that I can feel the firm ball of my expanded uterus now just above my pelvis. The rest of my abdomen is characteristically squigy, but at the south end there's definitely something firm underneath taking shape. We're past the danger window for a miscarriage now, and in a couple of weeks we'll get past the screens for chromosomal abnormalities and spinal defects, and then we're pretty much in the clear. We'll find out the baby's sex as soon as it's visible (pooper's was visible at the 12-week appointment), and spend the rest of the pregnancy arguing about names. I'm very, very happy.

1 comment:

Beth said...

Congratulations!!!

My ob.gyn is Dr. Bushart with Austin Regional Clinic and I absolutely adore him. Just thought I'd mention. :)

How exciting for you all!!