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Need advice on c/s ~ not happy :( - Page 3

post #41 of 62
I'm exploring the possibility of expressing a little before birth to make sure there is a supply of my colostrum on tap from the start, regardless of what happens at the birth. I know this might be psychologically counter productive if you've had a past of expressing, but it doesn't mean you have to give the milk, just that any care providers have NO EXCUSE to supplement with anything other than your milk, ( if it came to a topping up argument for any reason), and can be instructed to avoid bottles because they are *fully breastmilk babies*.

I know I have to be ready because our hospital is not baby friendly, it'll take an age to get pumps sorted if I need them at the time, and I really don't want anything other than my milk going in my babies. I feel like expressing ahead of time will give me peace of mind, demonstrate that I'm serious about breastfeeding and buy me some time if I ever need it, and it is part of the protocol of other hospitals (who have written guidelines for antenatal expressing), so I also know it's not an unreasonable thing to set up.

I guess the way I'm looking at the whole birth is that wherever I can get my voice and preferences heard I will feel more empowered, and that will be a good thing, even if I'm not ultimately in control!
post #42 of 62
I just wanted to say hugs. I havent had a cesarean myself (and tbh, I'm scared to death of having one-I had a bad experience with my mom's when I was 10 and its scarred me for life, lol), but I have a close friend who has had 3 in the last two years. Her first one was also for twins (she really didnt care, she never even bothered asking about VBAC with the other two), but they were preemies so it wont be quite the same. Even though they were 30 weekers, they still let her see and touch them quickly before taking them to the nicu.

Anyway-I wanted to ask, how is your dh? It doesnt sound like he thinks its as bad as you do....how does he feel about the babies being taken away for stuff? Do you think he will advocate-strongly-for you? If not, do you have any family or friends that can advocate? From what I've seen from her cesareans, as well as a couple other friends and even from my own *normal* hospital births, if you dont have someone who is STRONG WILLED and willing to put their foot down and tell them NO, they just wont listen. Admittidly every hospital and thier policies are different, as are each doctor, but I mean....with my first, they wouldnt let me hold him, took him to the nursery, asked me if they could give him a bottle, I said no and they did it anyway. I didnt have someone saying hey, she said no-so they did it anyway. With my 2nd it was completely different, as both myself and my dh were there saying NO-you will NOT give her a bottle, you will NOT take her out of the room, etc. My daughter literally only left my arms long enough to be weighed. In the case of a cesarean, I would insist my dh hold them the ENTIRE time. Unless there is a problem, theres no reason to bathe them right then (in fact, I feel its better to wait a day or two, the vernix will absorb on its own for the most part and it keeps baby from getting dry skin ), theres really no reason to even weigh them yet, and going for a little while without nursing isnt going to hurt them (babies in tribal communities frequently arnt nursed for a good 2-3 days! they view colostrum as evil). You can even halfway nurse while being stitched up if you prepare for it ahead of time. You'd be surprised what positions they can nurse in, lol.

Obviously, keeping them right there with you, being able to touch them, maybe even nurse a little, will help with the bonding. If they try to get some other milk in them, insist they use a cup or spoon-and make your dh WATCH to make sure. Yeah, I had nipple confusion with my first for 3 months because of that stupid bottle, so I very much understand! If, while you are still in the hospital, they are saying they want to supplement, insist on using a SNS or cup feed. Again, this will prevent nipple confusion, and with the SNS, you'd still be getting the stimulation from nursing. You might even want to buy one now, just in case. I also dont want to start a debate on circing but if you were planning on getting it done, I'd wait awhile to make sure breastfeeding is very well established. You and your dh just have to be very firm and not give in at all in any of this, you can do it!

And again, hugs! Good luck!!
post #43 of 62
I waited until the end of my 38th week to allow my doc to schedule a c/s. We did it at 39-1/2 weeks. Baby A was butt down and head up and Baby B was transverse

Those positions can you a dead set of twins if you go into labor and try for a natural.

Here's my story: the c/s was A BREEZE. I healed immediately, I had no complications, it was the easiest and best thing I did. I nursed my kids after having to pump for 8 weeks though and that was awful. The babies: Baby A was fine and healthy. Baby B needed a lot of suctioning and that's why Baby A never went away from her. She needed him!! Not knowing any of that, I prayed and I felt that it wasn't fair to try for a natural birth with Baby B transverse. If there is a complication, it is the 2nd baby that is usually lost. I didn't feel that was fair. It was a hard and painful decision but I am VERY glad that I followed my WONDERFUL OBGYN's advice and had a scheduled c/s. For sure, I would have lost my beautiful, cherished baby girl. I had to let go of my desire to have a natural birth and to hold 2 beautiful, perfect babies in my arms after a home waterbirth. It just wasn't going to happen for me. But, for sure, they're here, they're alive, they both nursed, we're happy at almost 5yo.

We had a wonderful pediatrician who gave me this advice, "Do what you can live with yourself later with." Had I lost my baby B, I never ever would have been able to live with myself later and that was my final decision. And it all worked out that I most certainly WOULD HAVE lost my Baby B in a natural birth. So, (((hugs))) and do some serious meditating/praying. What can YOU live with for however your birth turns out? Can YOU handle having a crappy birth experience? Can you take your chances? Does it mean that much to you? Much of what happens in a c/s depends on your pediatrician. Meet with your pediatrician ahead of time and ask all your questions about right after the c/s. Can you hold the babies? See the babies? Talk to the babies? How long before you can nurse them? What circumstances would the doc put them in NICU? Make sure you are comfortable with these answers and make some things you HAVE TO HAVE firm in your pediatricians mind! I HAD to see my babies the minute they were born. I did not get to hold them. My husband/their father went with them to the nurses room where they had their bath and assorted of prodding/poking that freaked me out. It was the best I could do under the circumstances and although that wasn't my ideal, it was MUCH better than losing my daughter to a horrible birth.

Stupidest recommendation I can make (but I believe it with all my heart) is that the birth is commented over and over on how important it is, but it isn't the rest of their lives and you have the whole rest of their lives to make it up to them if their birth wasn't perfect. Do what is the safest/best in YOUR mama's heart. They will love you with all of their little souls no matter how you get them here into the world.
post #44 of 62
Quote:
Originally Posted by BoyGirlTwinsAPMama View Post
Those positions can you a dead set of twins if you go into labor and try for a natural.
any birth of any baby or babies in any position vaginal or c-section holds in it the possibility of death for mother and/or baby. birth is only as safe as the rest of life. there are mothers here who birthed breech Baby A's with Baby B's in a variety of positions and have two healthy living babies to show for it. IMHO this is an awfully alarmist and possibly borderline cruel thing to post on a thread begun by a third trimester pregnant twin mom.

Quote:
Originally Posted by BoyGirlTwinsAPMama View Post
Stupidest recommendation I can make (but I believe it with all my heart) is that the birth is commented over and over on how important it is, but it isn't the rest of their lives and you have the whole rest of their lives to make it up to them if their birth wasn't perfect.
the birth is important not just merely to ensure a mother's satisfaction with the experience. life long physical birth trauma for mother and/or babies is a real risk in surgical birth. scheduled surgical birth, especially, has a statistically increased risk of such complications. i can understand where many educated women's fears of c-sections come from after examining the data. some women give birth surgically without any complications for themselves or their babies. others end up dealing with the ramifications of their birth experience for themselves and/or their babies long after it is over. there is no way to tell in advance which category a woman may fall into and neither possibility should be trivialized.

i do not envy the OP her decision making process, but having been pregnant with breech-breech twins and transfering from a homebirth to the hospital in labor for a c-section, i offer her my support and empathy as she navigates her way along this difficult path. and i also acknowledge and respect her need to process her fears and grieve the loss of more ideal birth circumstances.
post #45 of 62
Glad I waited to post my thoughts. I can just :
post #46 of 62
another "yeah that" as well!!!
post #47 of 62
First, : to everything 1sttimemummytolore said.

The dead babies comment is one of the most ridiculous and insensitive things I've ever heard said to a pregnant twin mom. First off, it's just rude. Secondly, it's not true, as many mothers here have had their twins with a breech baby A and transverse baby B at the start of labor, with no complications. Sounds like a not-nice scare tactic.

Quote:
Originally Posted by BoyGirlTwinsAPMama View Post
Stupidest recommendation I can make (but I believe it with all my heart) is that the birth is commented over and over on how important it is, but it isn't the rest of their lives and you have the whole rest of their lives to make it up to them if their birth wasn't perfect.
Here's the deal, though. Sometimes, a natural birth IS possible even with variations of the norm. Some moms really want to weigh their options to make sure that they are offering the most natural birth they can, not just for the birth experience-- but for the benefits that it offers both baby and mother. And even when they have determined that their Cesarean is necessary and know they will do it, they have a right to grieve that loss. Other than one post earlier in the thread, it seems like everyone has been respectful of where the OP finds herself-- hoping to avoid a Cesarean, but ready to commit to a Cesarean if it is necessary, and needing to vent and grieve if her natural birth plans are lost. She never once said that she wouldn't have a true medically necessary Cesarean; she just acknowledged that doing so would mean letting go of a dream.

This is the thing that bugs me about birth discussions on discussion boards. EVERYONE wants to impose their own experiences onto the original poster, when what we really could be doing to help is "listen," reflect, and support. Sounds like the OP has done her research and knows what risks and benefits she stands to experience from a Cesarean or natural birth. Let's just let her make the best decision she can, because so far she has said NOTHING that indicates she would intentionally put her babies at risk.
post #48 of 62
Congrats on your twins pregnancy!!!!!

I've had planned c/s due to prior uterine fibroid removal surgery that required a large incision.

Here's a little info based on my experience.

1. Both my boys were delivered at 37 weeks. At 36 weeks with each pregnancy, I had an amnio for lung maturity. This allows the doc to see basically if the lungs are ready. The babies do practice breathing in the womb and there is a substance in the amniotic fluid that can be measured and tested. With each pregnancy the babies were close at 36 weeks but the doc waited until 37 to schedule for added security that the lungs would be OK. Both my boys were born with no complications and were able to stay in the OR. My husband was there for each delivery and got to see the whole thing, I was able to hold and breastfeed each child quickly within the hour of birth. That was all awesome. I would recommend talking to your OB about an amnio for lung maturity at 36 weeks before scheduling a surgery. It may buy you more time and help ensure the kiddos are ready. They do an ultrasound during the amnio and the risks are that it may put you into labor but that's minimal, or that the needle would bump the baby or the babies would move and bump the needle. They aim towards a spot away from the babies faces, etc. I'm very happy to have this extra security even if it means an additional procedure.

For me c/s and fibroid surgery recoveries were not that bad. I would be more concerned with taking care of the twins and making sure you have enough help and support. People's experiences vary though based on their own bodies. In my deliveries the only thing that would have separated me from the babies would be if the babe needed NICU support (DH would go with then) or if I had a medical emergency -- something would go very wrong. But those are both very slim chances of happening.

I think the most important thing will be to relax about it and not freak out if that's the path you end up needing. Getting the spinal is a little uncomfortable, I was more nervous/scared with my 2nd c/s and I would be careful about managing your mental outlook, if that makes sense. Ask your doc and the hospital as many questions in advance as you need to feel comfortable.

Best wishes and good luck! Enjoy your twins!!!
post #49 of 62
Oh, in terms of hospital stays, mine were 4 days each, and I think you can negotiate that with your OB depending on how your recovery is going. It also may depend on how the babies are doing. With my son John, it was ridiculous because he had the slightest heart murmur and I was told he may not be released with me. Our pediatrician couldn't even hear the murmur at first and they were just a little dumb and scary about acting like the hospital pedi wouldn't release him, but we needed to wait to get that OK. I have found hospital stays very challenging for me, I feel isolated and lonely and it's hard on me, harder than the c/s birth. I also find the nursing staffing changes and shifts difficult, you'll get a great nurse and then a not very great nurse and youll have a lot of people and personalities to deal with. I think attitude matters here too, I know it's hard for me and so I'll try to cope the best I can with this next delivery. I think it takes a lot of patience and understanding and tolerance for a wide range of personality styles. I plan to take magazines, and a lot of things to entertain myself with. If only the hospital had wireless internet!!!! Talk in advance with your doc about how long the average stay is and plant the seed in advance that if everybody is doing great you may want to leave sooner. But you have some say in that, too. Keep the communication with your doc nice and open.
post #50 of 62
I would be shocked if they took the babies from the OR unless there were serious health issues. If that happens, and the babies need urgent medical care, your husband or partner should be allowed to go with them. Talk this out with your doc in advance to find out how it usually goes and if you need to negotiate.
post #51 of 62
IME, I could hold the baby in the OR and nurse in the recovery room. DS#1 needed to go under a lamp to get his temp up but the recovery nurse was great about having DS with me at times and then back under the lamp a little. I got a few good tries in with him and was satisfied there was a good balance b/w my nursing and his temp getting to where it needed to be.

With #2 there was less time to nurse in recovery, the recovery nurse was not friendly, she made a mean remark about my breast size. In retrospect I should have been more insistent about BFing in recovery, and having DH give the baby to me. It was OK but not as nice as the first hospital. And it's weird because #2's hospital won an WHO award for being BF friendly, the experience was worse.

You should expect or demand to hold and nurse the baby in recovery, IMO. I think you probably will get support for that but you may have to push for it. Be polite but direct and firm about it

IME both hospitals kept the babies in the OR for the initial health checks, APGAR, etc. It was in my view in both cases, maybe 10-15 feet from the operating table. My DH could go right over to watch and all I had to do was turn my head to the side to see the baby during that initial exam, weighing, etc.

Oh and my DH got to take photos of the birth/babies in both hospitals. The anesthesiologist at hospital #1 was nice and took a family photo of DH, me and #1 all in the hospital, me holding #1 on the hospital table and DH all gowned up.

ETA: All my experiences are with *planned* c/s not emergency c/s or c/s after labor. From everything I've seen, a c/s after the exhaustion of labor is harder and I don't know the emergency protocols, etc. It could be more intense in that case and could be very different from my planned c/s experiences. So I would ask your doc about they way they do it in planned and emergent situations.

Good luck with everything!!!
post #52 of 62
I just have to second (or third) what 1stTimeMummyToLore & christyc said. To BoyGirlTwinsAPMama, how on earth do you KNOW that your baby B would have died if you had tried for a natural birth? My baby B was transverse as well (transverse/breech). He was born vaginal and vertex 2 1/2 hours after his brother - I waited it out and he turned when he was good and ready w/o anyone laying a hand on him or me. And b/c of that he got the benefits of the natural squeezing that accompanies a vaginal birth.

Huge to the OP. I hope you're finding lots of great suggestions to make your experience a really great one.
post #53 of 62
Yeah, like I said, it depends on the hospital and the doc....I know at the hospital my friend had her kids at, they kept him in the room (she's only had one late enough that he was able to be kept out of the nicu-the doctor is a real interventionist freak imo), but she only got to touch him for a second and then they took him over to a warming bed and did his weight and all that, bundled him up, and then said ok, he needs a bath, and took him to the nursery. Again though, she isnt like me and wasnt saying give me my darned baby!! They also gave him bottles because he was still a little early and small because of that (I think he was a 36 weeker but doing fine, just smallish, around 5.5 pounds), but, again, she didnt fight it.

Saying that you *know* your second baby would have died if you tried for a natural delivery is just...silly. Sorry. But it is. It sounds like your docs have you convinced that this is the case or you've rationalized it this way, but its just not true. You have no way of knowing anything. You made the right decision for you and thats fine-but dont tell people that your baby WOULD have died, thats just crappy. As others have said, many have had breech first twins with the 2nd transverse and the second baby almost always moves once the first is out. Its still safer than some other positions. And, if for some reason, the 2nd baby stays transverse, you can still have a cesarean. Tbh, I dont know WHAT I'd decide if I were faced with this, but the OP has already decided and is grieving what she is losing. Its her choice and the right one for her and all she needs is support, not scare tactics.
post #54 of 62
Quote:
Originally Posted by ~Em~ View Post
First off, a planned c-s is MUCH easier as far as the actual surgery and recovery than one that is done in an emergency or after labor. It was like night and day with the last two, the planned one being much easier on everyone. Obviously vaginal would have been preferable, but it wasn't to be.
I'm sorry, but I must very, very strongly disagree with part of this.

I had an unexpected c/s after 14 hours of unmedicated labor. It was as wonderful as cesareans could get. I was up and walking within 8 hours. I was off pain meds within days, and out of the hospital with 36 hours.

So when it became obvious that I would need a planned c/s with the boys, due to the TTTS, cord placement, and both of them being very firmly transverse, I assumed that planned would be easier.

It was not. It was such a horrific experience that to this day, 5 years later, I have still never written my boys' birth story because I vomit from fear and anxiety when I try.

I dealt with chronic pain and anxiety for about a year afterwards. I didn't even leave the hospital for 4 days afterwards. I could barely walk when I did.

Don't make blanket assumptions. (though I can imagine what you said is very true for most emergency c/s, I wouldn't know, having never had one.)

So what I would say to the OP is that IF you find you need a planned c/s, it's not the end of the world--don't assume it will be easier, be sure that you and your birth partner advocate for you as fiercely as any other birth. Don't be afraid to ask the anesthesiologist questions as to what anesthetic they're using and why and ask what your options are (and if they're a good photographer it's a bonus, the one from my daughter's birth got us some really awesome photos!) Make sure your postpartum nurse knows you want to get up ASAP (make sure the anesthesiologist knows this as well so that s/he doesn't give you anything that requires you lay flat afterwards for a specific amount of time). Don't let nurses or doctors bully you about breastfeeding, it can be done and if you've got good nursers a c/s won't matter. None of my kids had a problem nursing afterwards, even though I was in bad shape after the boys' birth.

Just because something is "planned" doesn't mean it will be better. Sometimes it means you might be more likely to let your guard down. That's pretty much what I was stupid enough to do, and I have reaped a lot of suffering as a result. Perhaps if this is your first cesearean, you will be smarter than me. Because I had a great experience my first time, even though of course I was disappointed and afraid at first, I let myself get complacent about the second, and that was a big mistake.

So I am definitely not one to say that cearean births have to be awful. My daughter's was awesome. I have many happy memories of that day. But you must also be on your guard. I was feeling powerful having gone through a very difficult labor, I had a doula with me, as well as DH, I had my plan B in place, ect. With the boys I got complacent, didn't have a doula, assumed that what happened the first time (the med, ect.) would happen with that one, and I paid for it.
post #55 of 62
You can also talk to your doc beforehand about having the babies put on your chest right after they come out and doing any cleaning up they need to right there. [ You should be able to find the studies on the advantages of this c/s-to-chest birth (warmth from mother, bonding, more success with breastfeeding, etc.) if you'd like to bring those into your doc at your 38wk appt. ] Best of luck!
post #56 of 62
OP, I am sending you placenta-moving vibes! And also hugs.

I had a long response for the pp who believes her ob/gyn that her baby DEFINITELY would have died without a c-s, but I deleted it. Let's just say: there's no way to know. Babies move.

When I was pregnant with my twins, I was GUARANTEED that they wouldn't switch places, that the presenting baby would be born first. GUARANTEED. Guess what? My babies switched places around 32/33w, and the baby who was B for my entire pregnancy was born first. The baby who was A for my entire pregnancy (and who was also vertex) was born second -- and foot first.

Things change, even late in the game. Good luck, OP! Move, placenta, move!
post #57 of 62
Quote:
Originally Posted by shukr View Post
I'm exploring the possibility of expressing a little before birth to make sure there is a supply of my colostrum on tap from the start, regardless of what happens at the birth. I know this might be psychologically counter productive if you've had a past of expressing, but it doesn't mean you have to give the milk, just that any care providers have NO EXCUSE to supplement with anything other than your milk, ( if it came to a topping up argument for any reason), and can be instructed to avoid bottles because they are *fully breastmilk babies*.

I know I have to be ready because our hospital is not baby friendly, it'll take an age to get pumps sorted if I need them at the time, and I really don't want anything other than my milk going in my babies. I feel like expressing ahead of time will give me peace of mind, demonstrate that I'm serious about breastfeeding and buy me some time if I ever need it, and it is part of the protocol of other hospitals (who have written guidelines for antenatal expressing), so I also know it's not an unreasonable thing to set up.

I guess the way I'm looking at the whole birth is that wherever I can get my voice and preferences heard I will feel more empowered, and that will be a good thing, even if I'm not ultimately in control!
This is not a good idea. Nipple stimulation can cause premature labour. I used a pump to start labour with my DD1.
post #58 of 62
Thread Starter 
She never once said that she wouldn't have a true medically necessary Cesarean; she just acknowledged that doing so would mean letting go of a dream.

This is the thing that bugs me about birth discussions on discussion boards. EVERYONE wants to impose their own experiences onto the original poster, when what we really could be doing to help is "listen," reflect, and support. Sounds like the OP has done her research and knows what risks and benefits she stands to experience from a Cesarean or natural birth. Let's just let her make the best decision she can, because so far she has said NOTHING that indicates she would intentionally put her babies at risk.

No, I certainly would not risk the babies -- it's pretty silly actually to think someone would. I appreciate the posts to that effect; they fairly succinctly sum up how I feel.

And I respect that my providers cannot allow me to have a vaginal birth with my placenta right up to the edge of my cervix. There really isn't a lot of wiggle room. The head at the hospital is against it as is my very permissive OB. If we were talking more of a grey area, I'd be in protest. However, at this point my options would be to come in pushing (and hope I didn't bleed heavily during labor, the hospital isn't close) or to UC. I'm not comfortable with either option given all the circumstances.

One additional question: what drugs/narcotics were you given immediately afterwards? Does anyone have any suggestions on what to avoid? I've seen talk elsewhere of the anesthesiologist giving something that makes you feel loopy or drunk (something I'd like to avoid) but I'm not quite sure what to ask for
post #59 of 62
I was not given anything after my first cesarean, not even a painkiller until it got within a few hours of the epidural anesthetic wearing off. I was clearheaded for the entire time.

I was given dilaudid after my 2nd cesarean, and felt extremely disoriented (they put me under for awhile too, so that makes a different) and could not raise my head off the pillow without a horrific headache even through the painkillers, and I also had a lot of nausea. I was given a spinal for the 2nd cesarean, and I personally feel that probably I had a reaction to the different method or the different drug.

I'm not sure if it's common for some people to react more strongly to spinal vs. epidural, but that might be worth researching. I have heard many people tell of disorienting side effects from spinals, not so much from epis, unless it was done incompetantly.

Which for all I know might have been the problem with my spinal.
post #60 of 62
Quote:
Originally Posted by Heavenly View Post
This is not a good idea. Nipple stimulation can cause premature labour. I used a pump to start labour with my DD1.
The evidence is that it doesn't seem to - so if labour occurs it was probably going to happen anyway. The amount of oxytocin released in response to hand expressing about 3 x day would be fairly low. If you imagine that tandem feeders often go all the way through pregnancy stimulating the production of oxytocin, and that with orgasm we have a beautiful surge of the stuff, it gives an idea of perspective. B'feeding and intercourse/ orgasm can be the final trigger, but not in most people early on, or tandem feeding would be contraindicated full stop and we'd all be celibate

It might not be great for someone very early on in pregnancy where labour is trying to be stopped...but then I wouldn't be looking at expressing at say 24 weeks 'just in case'. If you know you're in for say a c section at 34/36 weeks for TTTS though, it might be very helpful to express a little colostrum ahead of the birth to have ready.
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