need c-section

[xtine]

i have had 2 vaginal births 6 and 3.5 years ago. everything went great but unfortunatly when my youngest was around 10 months i got an inner ear injury which caused CSF to leak down my throat.

the leak has never been found but some doctors i saw do suspect that's what i have... i am certain that is my issue and have taken to modifying my activity in order to allow for me to heal.

it's been about 3 years and i am doing much better although still leak and have to be careful about exurtion. we weren't trying for a baby but found out i was pregnant in the summer and am about to go in for a scheduled c/s on monday at approx 39-40 weeks.

i am really worried about the operation and i just don't like any medical intervention. i am debating if i should try a normal birth or if this is just dumb on my part. if i risk a re-injury to my ear, i could lose more hearing or put myself out of commission and not be able to look after the baby. i really don't want to go down the route of inner ear surgery or head surgery, CAT scans, MRIs etc...

i guess what i'm wondering if those who have had c/s think that my decision on a c/s is valid. i have no idea what the recovery time is and what the long term effects are but i am assuming they must be better than my alternative. i am unsure why someone who 'choose' a c/s either... just seems very scarey at the thought to me.

also- for those who have had a c/s how was recovery and the whole experience? are there any issues with bonding with the baby or breastfeeding that i should prepare myself for?

regards,
christine

[briome]

I have never heard of your reason for having a c-section. I'm curious how a leaking ear means you need surgery for childbirth? I'm sure I am misunderstanding your condition and would love to know more about your specific aliment.



Look here for some good ideas if you do end up getting one!
http://ican-online.org/pregnancy/fam...tered-cesarean

[Storm Bride]

I don't really understand the relationship between your medical condition and the need for a c/s, either. However, if it is medically necessary to have the c/s, is there any reason not to wait for labour to start and then go in? I know scheduling is touted as being best for the mother, but that hasn't been my experience. My two best section experiences, in many ways, were the two that were scheduled, but involved some labour first.

I can't really give you much info on the recovery. Mine have all been different. I do strongly recommend that you request stitches for the skin incision, instead of staples. I finally had stitches for my last one, and couldn't believe the difference in pain (much less) and mobility (much more). There's also a glue that can be used, but I don't have any first hand experience with it.

[xtine]

i have a Cerebrospinal Fluid (CSF) Leak in my ear. any pushing or straining makes me leak more fluid thus causing neurological symptoms ie headaches, tremors, vertigo, numbness + hearing loss.

in the past, straining to open a vaccuum sealed jar, blowing my nose, sneezing, riding in an elevator, having a difficult bowel movement or orgasiming during sex causes more of a leak. i imagine i would be able to manage thru labour but the pushing part would be difficult. if things go well- maybe i can avoid further damage but it comes to a point where i would need to push for an extended amount of time i could really hurt myself.

i don't test my condtion so i don't know how much i can handle. i still avoid what i can... but i am able to function a lot better now but still have to be careful about twisting my neck or lifting anything heavy (over 10-20lbs).

my condition is very unheard of and there is only one dr. that i have consulted with who really understands what is going on. he is in the US and doesn't take insurance.

although he's been kind enough to review my scans and invite me in for tests, i haven't seen him because i became pregnant and didn't want to worsen things with tests or try a surgery while pregnant. he usually recommends a c/s for people with this condition in order to avoid more damage to the inner ear.

i hope that clears it up... it's a complex situation and i just wish i had some more insight and help from the medical community.

[briome]

The advantage of waiting untill labor starts on it's own would be that your body and baby would be the signal that baby was ready, not some number (weeks pregnant) or schedule opening. Of course I don't know how the pushing stage of your other pregnancies has gone but not every birth has to have an exausting pushing stage.
Were you encouraged to do 'purple pushing' in your other births?
Do you leak fluid during a BM?
C-sections can cause recovery pain and certainly exertions, after mine just getting out of bed and holding my baby were full of exertions. All I am saying is that trading a possibly short, especially if well managed pushing stage for a difficult recovery after a surgery is NOT a clear choice. IF you let yourself labor and get to pushing and see how it goes and THEN choose a section only if needed at that point you could have a much easier recovery after birth. With this scenario you still have choices. Your doctor may try to convince you that this is not ideal, after all he/she has to labor sit the entire time and may discourage you with the excuse that an epidural may not be avalible etc....

I'm curious about what happens exactly when you leak this fluid?

How does the leaking damage your hearing? Can he offer assurances that the c-section surgery will not affect your condition as much as a vaginal birth?

[Storm Bride]

xtine: That definitely sounds as though a c-section would be in order. I'm not sure where the line would be drawn on how much straining you could handle, but I can see that pushing could be a real problem.

I'd definitely recommend waiting for labour. You might also want to search the net for "natural cesarean" or "empowered cesarean" (I don't like either term, but they're very common) for ideas about ways to make it a better experience for you and your baby.

Have you talked to your specialist about the stresses and strains of a c-section on your body? One of the very frequent effects of a c/s is constipation, for instance.

I don't envy you this situation at all. It sounds as though your condition is so rare that nobody really knows the best route to take.

[zoebird]

i agree with the others. it sounds like a good reason for a c-section to me (all things considered). i, also, would consider waiting for labor before going in, but that is entirely up to you of course. not waiting is also appropriate and acceptable if you think/feel that is best.

as far as recovery goes, i don't know about it, having not had a c-section myself. but i would talk to the surgeon about it.

another thing that i would talk to the surgeon about is respecting your birth. i read so many stories about mother's having their c-sections and the doctor's are talking about sports or vacations or other patients (and how "annoying" that person is) and so on while doing the surgery.

i would prefer the doctor either keep quiet or talk about what is going on with me and the baby.

[sweetsadie77]

If you and your care providers decide c-section is best then I'm sure you will find good advice from wonderful mdc mamas who've had c-sections.
But babies can be born gently without any additional pushing effort from mamas, especially if they've had a couple of babies before. What about an epidural so that you don't have a pushing urge and letting our uterus do the work? Or even some skilled use of outlet forceps or vacuum once your body gets the baby low enough to either of these things safely.
Have these options been discussed?

[RedOakMomma]

It is definitely advantageous to the baby to wait until labor begins to have a c-section.

...but in your case, it doesn't sound like that's a good idea. Pushing sounds like it could reinjure your leak, but I'm guessing that the strain and tension of contractions could do that as well. I would discuss it with the dr. that understands your condition and ask him about labor (contractions) and pushing. It may be that you want to avoid both.

And s to you. I had a botched spinal tap as a young adult, and it was leaking csf for days. Every time I stood up, I was dizzy, sick, throwing up, and had pounding headaches that felt like my brain was banging into the bottom of my skull. It was truly awful. I can see how you would want to avoid reinjury at almost any cost.

Best of luck with your pregnancy, and congratulations!

[Storm Bride]

Originally Posted by RedOakMomma

It is definitely advantageous to the baby to wait until labor begins to have a c-section.

...but in your case, it doesn't sound like that's a good idea. Pushing sounds like it could reinjure your leak, but I'm guessing that the strain and tension of contractions could do that as well. I would discuss it with the dr. that understands your condition and ask him about labor (contractions) and pushing. It may be that you want to avoid both.

I'd wondered about that, but from the way she describes the "triggers" (probably not the best word, OP, but I can't think of a better one), contractions really don't sound like they'd fall into the same category. The key thing (as far as I can tell) would be getting into the hospital fairly quickly once labour begins, in order to avoid pushing.

I definitely think you need to talk to your specialist. Do discuss the benefits of labour for the baby, too. Since he doesn't work in the OB field, he may not know anything about that at all.

[xtine]

thanks for your replies everyone. i met with the anesthesiologist today and he was very caring and open-minded.. (most doctors seem to dismiss my injury). he was considering putting me under a general and not a spinal to not risk any further CSF leaking or an additional CSF leak. we have decided to stick with the spinal as i have been improving for years and feels the risks are low enough. interesting that he said an epi is actually more invasive and combine that with pushing and that puts you at a bigger risk for a spinal leak. (either way- i would hope that if i did deliver vaginally i wouldn't need an epi but that's may be beyond my control)

i reviewed my notes with my neuro-otologist and he certainly recommened a c-section. being a member on this site i'm sure you'll relate that this is the farthest thing that i want... but i've weighed the pros and cons and feel it's safer this route compared to the possiblity of a setback and a future ear/head operation.

i'm not too concerned about waiting 'till labour before we do the c/s. it might sound selfish but i'm putting my needs before the baby because i have learned that if i'm not well- the baby will suffer anyways. i first got this injury when my 2nd was 10 months and still feel the guilt over not being able to lift him or not feeling well for years while he was under my care.

i am comforted by the fact that the c-section is booked very close to my due date. my other pregnancies went 8 (or more) days earlier than expected and my doctor didn't take that into account when 'deciding' on my due date. plus when i look at the date of conception it's earlier than the date my dr. decided upon too. there is actually a strong possiblity i won't make it 'till monday but we'll see.

so now- i just sit and wait. i am a bundle of nerves and realized today when waiting in the hospital that i must have some serious anxiety from getting so ill and not wanting to go back there again. i had so many less than favourable experiences with doctors plus a botched operation on my inner ear 1.5 years ago that just being around doctors brings on anxiety. the hardest part for me will be waiting 'till monday then trying to get thru the op aware of what is going on.

i've put so much out of my mind in order to carry on and stay strong for my family and it's really difficult to revisit it all again. i just hope i can stay strong and get thru this as best i can.

i really do appriciate your stories and understanding. it's sad that this is overshadowing the joy i should be feeling but hopefully soon enough i'll be in the thick of things and realize that it all worked out okay.

thanks again everyone and blessings to all!

[Storm Bride]

Given your history of shorter than average gestation, it sounds very unlikely that they'll take the baby too early, which would be my biggest concern with labour-free scheduling, personally.

Good luck. I hope everything goes well. The one thing I will mention is worry about what works for you during recovery. There are things that work for the majority of women, and some of them tend to be treated as if they're Holy Writ (I'm thinking "granny panties", the football hold for breastfeeding and a few others). They don't work for everybody. I've never been able to make the football hold work...but I've also never been bothered by the weight of the baby on my incision. Focus on what works for you, and don't worry about whether or not it's "supposed" to work after a c-section.

Wishing you a smooth surgery and a good recovery.

I have no suggestions for dealing with the pre-op nerves. I've never been through anything like your injury, but I also hate - and fear - the hospital. Being there makes me very anxious and edgy. I've never really found that anything helps, so I just grin and bear it (more "bear it" than "grin").

to you

[Climbergirl]

For me, the recovery was pretty hard. But that probably had a lot to do with never even thinking that I would end up with a c-section.

The ICAN site has a ton of info. But, I would ask that they keep the baby close (make sure there is not some weird, all c-section babies go to NICU kind of rule). As SOON as you get to recovery, as long as everything is ok, put the baby on you and start nursing. That will help with bonding and make sure the staff is clear on no pacifiers or bottles while they are finishing.

I had the glue. It was actually pretty cool because I did not have to go back to have stitches removed. They also put a bolus of novacaine directly into the incision to keep the pain levels down for a while. You will be on clear liquids until you fart, so you may want to keep that in mind. Took me a good 1.5 days to fart.

Make sure the hospital sends over the LC to help you with positions. And make sure someone is staying with you because nurses can get busy and I could not get out of bed for a while and could not reach into the bassinet to get the baby. I had to wake DH up to bring the baby to me.

Can't think of anything else. Good luck though and hope things go well for you!

[kltroy]

Best of luck with the c-section - it sounds like you've done your research and thought it through to make a good informed decision. There are many threads here on planning a better c-section, and you might contact your local ICAN chapter. As a local chapter leader, I've had several conversations both over the phone and in person with women who have, for a variety of reasons, opted to schedule c-sections and were looking for advice on what to expect and how to best plan it. (I like to think that they were helpful, though I don't always get feedback). The one thing that I will suggest (and have suggested on previous threads about scheduling c-sections) would be to watch a video of the surgery so that you have a sense of how it will all go. If you google "nih, video, cesarean section" you should come up with a library of surgery videos and c-section is one of them. Best of luck - I wish you a peaceful and joyous birth!

[Storm Bride]

Originally Posted by Climbergirl

The ICAN site has a ton of info. But, I would ask that they keep the baby close (make sure there is not some weird, all c-section babies go to NICU kind of rule). As SOON as you get to recovery, as long as everything is ok, put the baby on you and start nursing. That will help with bonding and make sure the staff is clear on no pacifiers or bottles while they are finishing.

I would never have thought it would happen, but I requested a feeding in the OR. It was declined...but when dd2 was crying, the L&D nurse who had prepped me (she was a midwife in the UK at some point) said, "she sounds hungry - do you want to try feeding her?", so we did. The OB was doing my tubal, and dh and the L&D nurse held dd2 over my shoulder, and she latched in an upside-down position. It was awesome.

[zoebird]

thank goodness for good nurses.

i think it sounds like you have all of your bases covered, ducks in a row, head on straight, and so on and so on OP.

i hope that your birth goes very well, and that you have a quick and smooth recovery.

[CherryBomb]

Sounds like the c/s is definitely in the best interest of your health, and because of that, best for your baby, too. I don't think it's selfish at all to be concerned with your ability to mother your baby if your CSF were exaggerated by labor or delivery. I know it sucks (my first two were c/s) but I'm sure you and baby will do great

[xtine]

hey everyone! i made it thru and out of the hospital successfully! have a little bundle of joy at home now and for that i'm greatful! thought i'd post my story here to share with whoever wants details:

Here is some info for those who might be getting their first c/s and what to know what to expect.

I had a scheduled C/S on the morning of Monday May 17th. This is my 3rd birth but first C/S. I needed this done due to prior health issues with an inner ear injury/csf leak and to say i was nervous was an understatement!!!

We were scheduled for 8AM but had to be at the hospital at 6AM. My mom arrived bright and early to watch our 2 boys and we left home around 5:30AM.

First thing DH does is drive too close to our fence and put a big dent into our van! It didn't phase me too much as I had other things on my mind! but a funny way to start the day.

We checked into the hospital and everyone seemed pretty nice and relaxed. They asked me health questions and monitored the baby. At this point I was having stomach cramps which could have been contractions. The nurse said that might be due to the stress.

The baby's heartbeat sounded good but she wasn't moving around. The nurses freaked me out about this because they're asking me when i felt the baby move last etc.. and I couldn't really recall. I did notice that she was moving less in the past few days.

Anywho- I was reassured that everything was fine and when it was time they got me to change into the hospital gown, get hooked up to an IV and go into the OR. They reviewed my health and because of my inner ear injury had to warn me of some additional risks that the spinal might do to me. I knew of the risks but it's always not nice hearing them right before i'm about the get the spinal.

DH was dressed and waiting for me in another room. The doctor was late so we had to wait for her before they started the spinal. I think at this point the nurses were trying to make small talk as they saw i was nervous and asking me about my other kids. this just made me sad to think of my kids and i cried. they comforted me and were really sweet.

finally my OB arrived and they started the spinal. i was really scared about this part and luckily the nurse stood by me and let me squeeze her arm (i'm sure i left welts) i flinched and i think she kind of missed the spot... she had to put in more atheistic after that i think). I was so stressed and wound up that it was hard for me to relax. i could feel the needle and it stabbing me in the back- it wasn't pleasant and probably took longer because of me being tense.

they lay me down once they were done and i immediately felt ill. i started gagging and dry heaving. i puked up some bile as there was nothing in my stomach. i felt queasy which was almost a good thing because it made me less anxious. they dr. put something in my IV to get my bloodpressure back up as it dropped pretty low 85/something from what i could see on the monitor.

finally they were ready for my DH and i'm sure he was freaking out as it took longer than expected. i felt much better with him near me and he kept me calm. the whole process didn't take too long and i felt the tugging/pulling that others have described. it actually felt like i was on a roller coaster and didn't bother me too much.

i managed to stay focused on the baby's arrival. just as the baby was about to come out, the dr. asked if DH had his camera ready.. of course he forgot it in the waiting room! so he had just a few seconds to run out, get it and run back with it.

the baby was pulled out and she looked great! a 8lbs 3oz baby girl! i had tears of joy at this point. they cleaned her up and placed her skin to skin with DH (i love that they offered this to DH and i think he'll have a special bond with the bby) as they stitched me up. the strange thing is i could feel each stitch pulling my body but i didn't feel the pain. the closing seemed to take a while and i was getting impatient to leave. DH reminded me that it's better that they're careful and do a good job and not rush!

anyways- after i was closed they wheeled me into recovery and i got to hold the baby. i spend about 1 hr in recovery before i was whisked away to my hospital room. i was still numb but i think the local was starting to wear off at this point just a bit.

healing from a c/s is a much longer process than my vaginal births. i was on painkillers (advil and tylenol) for several days and spent 2 nites in the hospital. i think they only checked me out early because this is my 3rd baby and they could see i had everything under control with her.

the hospital stay was pretty miserable. DH got sick the first day and left to go home to sleep. I was left alone my first nite which was really hard.. i couldn't sit up very well and it was hard lifting the baby in and out of the bassinet. honestly, i don't even recall how i managed but i think i didn't sleep and held the baby a lot.

the 2nd day wasn't any better as DH was still not around and feeling worse. my mother came to help but didn't stay too long as she had to get my grandmother to come see the baby.

luckily later that day i was moved into a private room, got to shower and was feeling like i could move around better. i had a good sleep that nite and was able to check out the next afternoon!

at home now and still recovering. i'm taking advil when needed but trying not to take too much. it's hard to rest with 2 boys and a newborn! plus I got DH's cold/virus and have been feeling sick from that too! the worse is when i have to cough and i just hope that doesn't set me back or cause any additional damage. thankfully, the baby didn't get sick and there is so much i'm grateful for. today is the first day i feel like i'm turning the corner in terms of my cold.

looking forward to the weekend and spending it with my family! it has been a long ride but well worth it in the end!!

christine

[Storm Bride]

IME, coughing doesn't make the damage any worse, even though it hurts a lot.

I find that at about 3-4 days post-op, I feel a jump in how well I'm feeling...then another one sometime around two weeks out. IME, two weeks out is the danger zone. You'll have a few aches, but feel so much better that you'll almost forget you had major surgery, and you'll be frustrated out of your mind by trying to look after three kids in that state, and you'll be tempted to do too much. Don't. I make this mistake over and over and over...and end up taking forever to fully bounce back.

[RedOakMomma]

Congratulations! Rest up, and it sounds like StormBride has great advice...STAY RESTING! I'm so glad it all went well for you, mama!