Upcoming C-section requiring vertical (classical) incision!

[rachelr2]

I am looking for data, advice and reassurance from anyone on having a cesarean requiring a vertical incision. Becasue of a fetal abnormality requiring a larger incision, we have no choice and I am really scared of the whole thing. Can anyone help me?

[alegna]

I would get a second and third opinion. The only times I've heard of a classical being done is for a VERY pre-term baby or a baby they tried the other way and couldn't get out.

good luck!

-Angela

[OnTheFence]

Angela sometimes a vertical incision is required when a baby had a certain abnormality because it makes it easier to get the baby out and will cause less damage to the baby than trying to manipulate it out of a biki cut incision. My sister worked in a fetal anomaly clinic for nearly three years, and believe me preterm is not the only reason to deliver a baby through a vertical incision. I'm sure the above poster has probably seen more than just her OB if her baby has an anomaly don't just assume that one person has told her this is the only way.

As to the OP, I would strongly advise getting an epidural instead of spinal so that you can be redosed during the surgery. A classical csection with a baby that has a birth defect will often take longer, sometimes 30 minutes longer. Also request to be completely sutured instead of stapled. This will give you a "better" looking scar and make you feel better put together. Have a firm pillow to hold against you to cough and get up to move once you get moving. It is going to hurt to bend and you will probably have a longer recovery time -- I personally would stay the full 96 hours your insurance will allow so you can have optimium pain management. Breastfeeding may be difficult (if you will be able to breastfeed), so if your baby can nurse, try the football hold or even the side lying position. Take pain meds on time, and don't be discouraged to take narcotics -- you will have so much going on with your baby that you will need to be pain free.

The biggest hurdle will be getting up and moving around the first few times and using the bathroom. Have adequate support and always call for the nurse when you do this. Even though it will hurt, moving around will be the best thing for you to do. Eat well and be sure to eat fiber and take a stool softner.

Some girls on the csection support thread may have some other advice for you. If you don't mind could you share with us what is wrong with your baby?

Take care,
Kim

[alegna]

Thanks Kim! Kim is our resident c-section expert. Should have know she'd know more than I would.

-Angela

[MizLiz]

subscribing

I don't really have anything to add but after having had two previous sections I'm always interested to find about other peoples experiences with them.

Best of luck!

[rachelr2]

Thanks to you all for your thoughts - it is so helpful to hear back so quickly. Our baby boy has a very strange abnormality not see before by the fetal-maternal community in Boston. He has what is called a lymphangeoma - a fluid-filled distension under his right arm. It is not a separate growth, but is under his skin. He is 27 weeks at this point and already the width of the distension is 4.75cm. It is between 2/3 and 3/4 the size of this entire abdominal cavity! Like you or I holding a basketball under our arm. He is doing great otherwise (strong heart and system, no concerns about a chromosomal problem) but will require surgery at some point. What the "team" says is that they will have to drain as much fluid as possible by needle before prepping me for the csection. They hope to drain enough to help make the delivery easier on him and me. They have already said they expect this to be difficult. I asked about the repairs and they said they will sew it up in 3 layers. They plan to give a spinal for this (I asked about epidural and they said they prefer the spinal in this case???). I just need reassurance that I am going to be okay at this point. They keep saying how HE will be okay, but what about me? Won't we BOTH be okay? Scary. Any other suggestions or questions we should be asking?

[MamaTaraX]

There is someone else here who is having a baby with a lymphangeoma (sp??) under baby's arm! I wish I could remember the title of the post! You might want to seek a second opinion on regards to the type of c/s incision. I've only read about a couple of cases of this and the moms did not have classical incisions, however, I think they were able to drain a large portion of the fluid before delivery, so that might have made a difference.
The difference between spinal and epidural is mainly int he time they take to set up and how long they last. A spinal sets up faster and lasts longer. An epidural takes longer to set up, requires a catheter left in place and doesn't last aslong, it has to be re-dosed. Spinals can be dosed to last many hours. There are advantages and disadvantages toboth in terms of c/s and recovery.
I'd writemore but I have to go. Best wishes!

Namaste, Tara
mama to Doodle (6), Butterfly (2), and Rythm (due at home 1/06)

[ldsapmom]

(((hugs))) to you and your baby. I am sure your medical team has you in the underlying equation when assuring you baby will be fine -- you are his mother, you are an integral part of who this baby is and who he will be after birth -- they probably are just so focused on what the baby's immediate needs are that they are assuming you know you will be okay. Don't be afraid to ask about this, though. You could phrase it just like you did here, "I feel good that you assure me my baby is going to be taken well care of, but I have some concerns about my own health -- what are your ideas about what I can expect?" I am sure you will get some great support once they understand (or remember) that you are very much going through this procedure yourself. Sometimes I think they get so caught up in the immediate goal (getting baby safely delivered) they don't always have the best bedside manner we as adults need.

Good luck, and keep us posted. I will be thinking about you two . Can't wait to read your birth story.

Stacie

[rachelr2]

THANK YOU THANK YOU! It is helping me to hear from you all on this. I think the past post you saw was based on my case - my friend who introduced me to Mothering posted it for me. I will keep you up to date and try to relax int eh meantime. I just found all this out yesterday so I am still freaked out and trying to deal with it. This support network is really a blessing.

Rachel